Central Photoreceptor Viability and Prediction of Visual Outcome in Patients with Idiopathic Macular Holes
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Purpose: To identify the correlation between preoperative optical coherence tomography (OCT) features and postoperative visual outcomes in eyes with idiopathic macular holes (MHs). Methods: Data from 55 eyes with idiopathic MHs which had been sealed by vitrectomy were retrospectively reviewed. Correlation analysis was conducted between postoperative visual acuity (Vpostop, logarithm of the minimum angle of resolution [logMAR]) and preoperative factors, including four OCT parameters: the anticipated length (A) devoid of photoreceptors after hole closure, MH height (B), MH size (C), and the grading (D) of the viability of detached photoreceptors. Additionally, the formula for the prediction of visual outcome was deduced. Results: Vpostop was determined to be significantly correlated with the preoperative visual acuity (Vpreop) and OCT parameters A, C, and D (p<0.001). Based on the correlation, the formula for the prediction of Vpostop was derived from the most accurate regression analysis: Vpostop=0.248×Vpreop+1.1×10-6×A2–0.121×D+0.19. Conclusions: The length and viability of detached photoreceptors are significant preoperative OCT features for predicting visual prognosis. This suggests that, regardless of the MH size and symptom duration, active surgical intervention should be encouraged, particularly if the MH exhibits good viability in the detached photoreceptor layer.
Abstract
Purpose: To identify the correlation between preoperative optical coherence tomography (OCT) features and postoperative visual outcomes in eyes with idiopathic macular holes (MHs). Methods: Data from 55 eyes with idiopathic MHs which had been sealed by vitrectomy were retrospectively reviewed. Correlation analysis was conducted between postoperative visual acuity (Vpostop, logarithm of the minimum angle of resolution [logMAR]) and preoperative factors, including four OCT parameters: the anticipated length (A) devoid of photoreceptors after hole closure, MH height (B), MH size (C), and the grading (D) of the viability of detached photoreceptors. Additionally, the formula for the prediction of visual outcome was deduced. Results: Vpostop was determined to be significantly correlated with the preoperative visual acuity (Vpreop) and OCT parameters A, C, and D (p<0.001). Based on the correlation, the formula for the prediction of Vpostop was derived from the most accurate regression analysis: Vpostop=0.248×Vpreop+1.1×10-6×A2–0.121×D+0.19. Conclusions: The length and viability of detached photoreceptors are significant preoperative OCT features for predicting visual prognosis. This suggests that, regardless of the MH size and symptom duration, active surgical intervention should be encouraged, particularly if the MH exhibits good viability in the detached photoreceptor layer.
참고문헌 (26)
- Sjaarda RN, "Macular hole. In:Retina. 4th ed. Vol. 3, Surgical retina", pp.2527~2542 (2006), Elsevier
- Smiddy WE, "Internal limiting membrane peeling in macular hole surgery", Ophthalmology, 108, pp.1471~1476 (2001)
- Freeman WR, "Vitrectomy for the treatment of full-thickness stage 3 or 4 macular holes: results of a multicentered randomized clinical trial. The Vitrectomy for Treatment of Macular Hole Study Group", Arch Ophthalmol, 115, pp.11~21 (1997)
- Mester V, "Internal limiting membrane removal in the management of full-thickness macular holes", Am J Ophthalmol, 129, pp.769~777 (2000)
- Smiddy WE, "Macular hole surgery without using adjunctive additives", Ophthalmic Surg Lasers, 28, pp.713~717 (1997)
- Kasuga Y, "Optical coherence tomograghy to confirm early closure of macular holes", Am J Ophthalmol, 130, pp.675~676 (2000)
- Brooks HL Jr, "Macular hole surgery with and without internal limiting membrane peeling", Ophthalmology, 107, pp.1939~1948 (2000)
- Lai MM, "Anatomical and visual outcomes of idiopathic macular hole surgery with internal limiting membrane removal using low-concentration indocyanine green", Retina, 27, pp.477~482 (2007)
- Banker AS, "A multicentered clinical study of serum as adjuvant therapy for surgical treatment of macular holes: Vitrectomy for Macular Hole Study Group", Arch Ophthalmol, 117, pp.1499~1502 (1999)
- Cheng L, "Effects of preoperative and postoperative epiretinal membranes on macular hole closure and visual restoration", Ophthalmology, 109, pp.1514~1520 (2002)
- Ullrich S, "Macular hole size as a prognostic factor in macular hole surgery", Br J Ophthalmol, 86, pp.390~393 (2002)
- Haritoglou C, "Long-term functional outcome of macular hole surgery correlated to optical coherence tomography measurements", Clin Experiment Ophthalmol, 35, pp.208~213 (2007)
- Uemoto R, "Macular configuration determined by optical coherence tomography after idiopathic macular hole surgery with or without internal limiting membrane peeling", Br J Ophthalmol, 86, pp.1240~1242 (2002)
- Villate N, "Photoreceptor layer features in eyes with closed macular holes: optical coherence tomography findings and correlation with visual outcomes", Am J Ophthalmol, 139, pp.280~289 (2005)
- Kang SW, "Types of macular hole closure and their clinical implications", Br J Ophthalmol, 87, pp.1015~1019 (2003)
- Guyer DR, "Histopathologic features of idiopathic macular holes and cysts", Ophthalmology, 97, pp.1045~1051 (1990)
- Funata M, "Clinicopathologic study of bilateral macular holes treated with pars plana vitrectomy and gas tamponade", Retina, 12, pp.289~298 (1992)
- Frangieh GT, "A histopathologic study of macular cysts and holes", Retina, 1, pp.311~336 (1981)
- Srinivasan VJ, "High-definition and 3-dimensional imaging of macular pathologies with high-speed ultrahigh-resolution optical coherence tomography", Ophthalmology, 113, pp.e1~14 (2006)
- Hangai M, "Three-dimensional imaging of macular holes with high-speed optical coherence tomography", Ophthalmology, 114, pp.763~773 (2007)
- Sjaarda RN, "Resolution of an absolute scotoma and improvement of relative scotomata after successful macular hole surgery", Am J Ophthalmol, 116, pp.129~139 (1993)
- Ji Eun Lee, "Reorganization of Photoreceptor Layer on Optical Coherence Tomography Concurrent with Visual Improvement after Macular Hole Surgery", Korean Journal of Ophthalmology, 22(2), pp.137~142 (2008), 대한안과학회
- Kusuhara S, "Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes", Am J Ophthalmol, 138, pp.709~716 (2004)
- Smiddy WE, "Transforming growth factor-beta 2 significantly enhances the ability to flatten the rim of subretinal fluid surrounding macular holes: preliminary anatomic results of a multicenter prospective randomized study", Retina, 13, pp.296~301 (1993)
- Paques M, "Effect of autologous platelet concentrate in surgery for idiopathic macular hole: results of a multicenter, double-masked, randomized trial. Platelets in Macular Hole Surgery Group", Ophthalmology, 106, pp.932~938 (1999)
- Kim SS, "Outcomes of sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) gas tamponade for macular hole surgery", Retina, 28, pp.1408~1415 (2008)