Clinic research of visual acuity improvement in early stage after pars plana vitrectomy of idiopathic macular holes

Abstract

Objective To investigate the risk factors that effect postoperative visual acuity improvement of idiopathic macular hole in early stage. Methods Retrospective observational case series.Fifty-four eyes of 54 subjects who had undergone pars plana vitrectomy with inner limiting membrane (ILM) peeling for the treatment of idiopathic macular hole were included.The main outcome measures included pre- and postoperative 3 months clinical examination and SD OCT findings:the factors of the macular hole and the maximum diameters of the disruption of the junction between inner/outer segments of the photoreceptors.Subjects were divided into 2 groups according to the improvement in log MAR visual acuity:group A had improved visual acuity ≥0.31ogMAR;Group B had improved less then 0.31ogMAR or had worsening of BCVA. Results Thirty-four eyes had ILM peeling with ICG staining; all eyes had MH anatomically closed; group A had 35 eyes (64.8％) where as group B had 19 eyes (35.2％).Minimal diameter,tractional hole index,postoperative maximum diameter of disruption of inner/outer segments,the grading of viability of detached photoreceptors,ICG staining were statistically significant (t =3.96,-5.04,6.10,P =0.000,0.000,0.000; 2=16.89,12.38,P =0.000,0.000,respectively).Logistic regression analysis identified that tractional index,postoperative maximum diameter of disruption of inner/outer segments,the grading of viability of detached photoreceptors,without ICG staining were risk factors in visual acuity improvement (OR=114.78,26.88,24.19,81.75;P =0.046,0.011,0.030,0.034,respectively). Conclusions Above results can provide a simple model to evaluate visual recovery of idiopathic macular hole after surgery. Key words: Idiopathic macular hole; Pars plana vitrectomy; ILM peeling; Optic coherence tomography; Risk factors