Abstract
BackgroundTo determine whether it would be effective in predicting the results of the postoperative full-thickness macular hole (FTMH) closure when intraretinal cyst (IRC) is present.MethodsCase-control study. Patients with idiopathic FTMH who underwent pars plana vitrectomy with internal limiting membrane peeling were retrospectively reviewed. Preoperative spectral-domain optical coherence tomography was undertaken in all patients. The new parameter, macular hole closing factor (MHCF) was defined as the base diameter - (arm length + IRC height) by adding IRC to the existing parameter. After surgery, patients were classified and analyzed according to the type of hole closure and the damage of photoreceptor.ResultsOf the 35 patients, 28 (80.00%) had type 1 closure and seven (20.00%) had type 2 closure. There was a significant difference in postoperative BCVA (P < 0.01), base diameter (P = 0.037), arm length (P = 0.045), and IRC height (P = 0.011) between the two groups. In the type 1 closure, they were further divided into two subgroups according to photoreceptor damage, and it was confirmed that there were significant differences in postoperative BCVA (P = 0.045), hole height (P = 0.048), and IRC height (P = 0.046) in the two subgroups. As for the new parameters, a significant difference between the three groups was confirmed (P < 0.01).ConclusionIRC may help predict hole closure along with the known horizontal parameters. Therefore, the new parameter containing both two factors can help predict not only hole closure but also damage to photoreceptors that affects postoperative visual prognosis.
Highlights
To determine whether it would be effective in predicting the results of the postoperative full-thickness macular hole (FTMH) closure when intraretinal cyst (IRC) is present
Idiopathic full-thickness macular hole (FTMH) is a disease that shows cystic changes accompanied by a defect in the neurosensory retina at the macula and is accompanied by severe central vision loss
The results of our study can be summarized as follows: (1) It could help predict the closure of FTMH through SD-optical coherence tomography (OCT) parameters: base diameter, minimal hole diameter, apex diameter, arm length, IRC height, macular hole closing factor (MHCF): base diameter
Summary
To determine whether it would be effective in predicting the results of the postoperative full-thickness macular hole (FTMH) closure when intraretinal cyst (IRC) is present. Among OCT parameters, studies have determined the anatomic success of MH surgery according to the size of the hole diameter [10, 11]. In addition to hole size, various studies have been published explaining derivative indicators; macular hole index (MHI), tractional hole index, hole form factor (HFF), and diameter hole index [11, 13, 14]. The disadvantage with these indices is that they consider primarily one of the two tractional forces for MH formation. Another study showed better anatomic closure and improvement of best-corrected visual acuity (BCVA) in the MH configuration with a cuff of subretinal fluid at the broken margin [16]
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