Öz
Aim: To evaluate the effect of preoperative Spectral Domain Optical Coherence Tomography (SD-OCT) parameters on macular hole surgery (MHS) and their predictive value for postoperative best corrected visual acuity (BCVA).
Materials and Methods: This retrospective study included 30 eyes of 30 patients with macular hole (MH). All patients underwent pars plana 23-gauge vitrectomy. A detailed macular analysis including MH minimum diameter (MD), base diameter (BD), opening diameter (OD), height, nasal arm (NA), temporal arm (TA), macular hole index (MHI), diameter hole index (DHI), tractional hole index (THI), hole form factor (HHF), macular hole area (MHA), and macular hole volume (MHV) were performed preoperatively. Presence of inner segment–outer segment (IS/OS) line, external limiting membrane (ELM), and cyst was noted postoperatively. Relationships between these parameters and postoperative BCVA were evaluated.
Results: The study group comprised 25 (83.3%) women. Mean pre and postoperative BCVA values were 0.924±0.320 and 0.487±0.287 logMAR, respectively. BCVA improved significantly after MHS (p<0.001). There was a statistically positive correlation between postop BCVA (logMAR) values, and NA (p=0.041), HFF (p=0.048), OD (p=0.045) and symptom duration before MHS (p=0.032). Postoperative BCVA was significantly better in patients with postoperative IS/OS line and ELM presence compared to those without (p=0.002 and p=0.002, respectively). The NA, postoperative IS/OS and ELM variables were found to be effective on postoperative BCVA (logMAR).
Conclusion: In this study, NA was determined as a predictive factor for the first time and together with NA, presence of IS/OS line and ELM were identified as predictive factors for visual prognosis after MHS.
Anahtar Kelimeler
Kaynakça
- Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013; 120: 2611-9.
- Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol 2002; 86: 390-3.
- Oh J, Smiddy W, Flynn H, et al. Photoreceptor inner/outer segment defect imaging by spectral domain OCT and visual prognosis after macular hole surgery. Invest Ophthalmol Vis Sci 2010; 51: 1651-8.
- Ooka E, Mitamura Y, Baba T, et al. Foveal Microstructure on Spectral-Domain Optical Coherence Tomographic Images and Visual Function After Macular Hole Surgery. Am J Ophthalmol 2011; 152 (2) :283-90.
- Wilczyński T, Heinke A, Niedzielska-Krycia A, et al. Optical coherence tomography angiography features in patients with idiopathic full-thickness macular hole, before and after surgical treatment. Clinical Interventions in Aging 2019; 14: 505-14.
- Michalewska Z, Michalewski J, Nawrocki J. Continuous changes in macular morphology after macular hole closure visualized with spectral optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010; 248: 1249-55.
- Shimozono M, Oishi A, Hata M, et al. Restoration of the photoreceptor outer segment and visual outcomes after macular hole closure: spectral-domain optical coherence tomography analysis. Graefes Arch Clin Exp Ophthalmol 2011; 249: 1469-76.
- Itoh Y, Inoue M, Rii T, et al. Correlation between length of foveal cone outer segment tips line defect and visual acuity after macular hole closure. Ophthalmology 2012; 119: 1438-46.
- Wakabayashi T, Fujiwara M, Sakaguchi H, et al. Foveal microstructure and visual acuity in surgically closed macular holes: spectral-domain optical coherence tomographic analysis. Ophthalmology 2010; 117: 1815-24.
- Bottoni F, De Angelis S, Luccarelli S, et al. The dynamic healing process of idiopathic macular holes after surgical repair: a spectral-domain optical coherence tomography study. Invest Ophthalmol Vis Sci. 2011; 52: 4439-46.
- Kusuhara S, Teraoka Escaño MF, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol 2004; 138 (5): 709-16.
- Ruiz-Moreno JM, Staicu C, Piñero DP, et al. Optical coherence tomography predictive factors for macular hole surgery outcome. Br J Ophthalmol 2008; 92 (5): 640-4.
- Kumagai K, Ogino N, Hangai M, et al. Percentage of fellow eyes that develop full-thickness macular hole in patients with unilateral macular hole. Arch Ophthalmol 2012; 130: 393-4.
- Jackson TL, Nicod E, Angelis A, et al. Vitreous attachment in age-related macular degeneration, diabetic macular edema, and retinal vein occlusion: a systematic review and metaanalysis. Retina 2013; 33: 1099-108.
- Ophir A, Trevino A, Fatum S. Extrafoveal vitreous traction associated with diffuse diabetic macular oedema. Eye 2010; 24: 347-53.
- Chablani J, Khodani M, Hussein A, et al. Role of macular hole angle in macular hole closure. Br J Ophthalmol 2015; 99: 1634-8.
- Shukla SY, Afshar AR, Kiernan DF, et al. Outcomes of chronic macular hole surgical repair. Indian J Ophthalmol 2014; 62: 795-8.
- Rahimy E, McCannel CA. Impact of internal limiting membrane peeling on macular hole reopening: A systematic review and meta-analysis. Retina 2016; 36: 679-87.
- Geng XY, Wu HQ, Jiang JH, et al. Area and volume ratios for prediction of visual outcome in idiopathic macular hole. Int J Ophthalmol 2017; 10 (8): 1255-60.
- Chalam KV, Murthy RK, Gupta SK, et al. Foveal structure defined by spectral domain optical coherence tomography correlates with visual function after macular hole surgery. Eur J Ophthalmol 2010; 20: 572-7.
- Chang LK, Koizumi H, Spaide RF. Disruption of the photoreceptor inner segment-outer segment junction in eyes with macular holes. Retina 2008; 28: 969-75.
- Baba T, Yamamoto S, Arai M, et al. Correlation of visual recovery and presence of photoreceptor inner/outer segment junction in optical coherence images after successful macular hole repair. Retina 2008; 28: 453-8.
- Inoue M, Watanabe Y, Arakawa AC. Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes. Graefes Arch Clin Exp Ophthalmol 2009; 247: 325-30.
- Okamoto T, Shinoda H, Kurihara T, et al. Intraoperative and fluorescein angiographic findings of a secondary macular hole associated with age-related macular degeneration treated by pars plana vitrectomy. BMC Ophthalmology 2014; 14: 114-7.
- Baek S, Lee WJ, Park KH, et al. Health screening program revealed risk factors associated with development and progression of papillomacular bundle defect. EPMA Journal 2021; 12: 41-55.
- Ling L, Liu Y, Zhou B, et al. Inverted internal limiting membrane flap technique versus internal limiting membrane peeling for vitrectomy in highly myopic eyes with macular hole-induced retinal detachment: an updated meta-analysis. Hindawi Journal of Ophthalmology 2020;1-9.
- Yuan J, Zhang LL, Lu YJ, et al. Vitrectomy with internal limiting membrane peeling versus inverted internal limiting membrane flap technique for macular hole-induced retinal detachment. A systemic review of literature and meta-analysis. BMC Ophthalmology 2017; 17: 219.
- Theodossiadis PG, Grigoropoulos VG, Theodossiadis GP. The significance of the external limiting membrane in the recovery of photoreceptor layer after successful macular hole closure: a study by spectral domain optical coherence tomography. Ophthalmologica 2011; 225: 176-84.
- Kaz´mierczak K, Stafiej J , Stachura J, et al. Long-Term Anatomic and Functional Outcomes after Macular Hole Surgery. Hindawi Journal of Ophthalmology 2018; 1: 1-9.
- Vaziri K, Schwartz SG, Kishor KS, et al. Rates of Reoperation and Retinal Detachment Following Macular Hole Surgery. Ophthalmology 2016; 123 (1): 26-31.
Öz
Amaç: Preoperatif Spectral Domain Optik Koherens Tomografi (SD-OKT) parametrelerinin makuler hol cerrahisi (MHC) üzerindeki etkisini ve bu parametrelerin postoperatif en iyi düzeltilmiş görme keskinliği (EİDGK) için tahmini değerini değerlendirmek.
Gereç ve Yöntemler: Bu retrospektif çalışmaya makuler holü (MH) olan 30 hastanın 30 gözü dahil edildi. Tüm hastalara 23-gauge pars plana vitrektomi uygulandı. Preoperatif olarak minimum çap (MÇ), taban çapı (TÇ), açılış çapı (AÇ), yükseklik, nazal kol (NK), temporal kol (TK), makuler hol indeksi (MHİ), çap hol indeksi (ÇHİ), traksiyonel hol indeksi (THİ), hol form faktörü (HFF), makuler hol alanı (MHA) ve makuler hol hacmi (MHV) içeren detaylı bir makula analizi yapıldı.
Postoperatif olarak iç-dış segment (IS/OS) bandı, external limitan membran (ELM) ve kist varlığı belirtildi. Bu parametreler ile postoperatif EİDGK arasındaki ilişkiler değerlendirildi.
Bulgular: Çalışma grubu 25 (%83,3) kadından oluşuyordu. Pre-postoperatif ortalama EİDGK değerleri sırasıyla 0,924±0,320 ve 0,487±0,287 logMAR idi. EİDGK, MHC'den sonra anlamlı derecede arttı (p<0,001). Postop EİDGK (logMAR) değerleri ile NK (p=0,041), HFF (p=0,048), AÇ (p=0,045) ve MHC öncesi semptom süresi arasında istatistiksel olarak pozitif korelasyon vardı (p=0,032). Postoperatif IS/OS bandı ve ELM varlığı olan hastalarda, olmayanlara göre postoperatif EİDGK anlamlı derecede daha iyi idi (sırasıyla, p=0,002 ve p=0,002). NK, postoperatif IS/OS bandı ve ELM değişkenlerinin postoperatif EİDGK (logMAR) üzerinde etkili oldukları bulundu.
Sonuç: Bu çalışmada NK ilk kez prediktif bir faktör olarak belirlendi ve NK ile birlikte IS/OS bandı ve ELM varlığı MHC sonrası görme prognozu için prediktif faktörler olarak belirlendi.
Anahtar Kelimeler
Kaynakça
- Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013; 120: 2611-9.
- Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol 2002; 86: 390-3.
- Oh J, Smiddy W, Flynn H, et al. Photoreceptor inner/outer segment defect imaging by spectral domain OCT and visual prognosis after macular hole surgery. Invest Ophthalmol Vis Sci 2010; 51: 1651-8.
- Ooka E, Mitamura Y, Baba T, et al. Foveal Microstructure on Spectral-Domain Optical Coherence Tomographic Images and Visual Function After Macular Hole Surgery. Am J Ophthalmol 2011; 152 (2) :283-90.
- Wilczyński T, Heinke A, Niedzielska-Krycia A, et al. Optical coherence tomography angiography features in patients with idiopathic full-thickness macular hole, before and after surgical treatment. Clinical Interventions in Aging 2019; 14: 505-14.
- Michalewska Z, Michalewski J, Nawrocki J. Continuous changes in macular morphology after macular hole closure visualized with spectral optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010; 248: 1249-55.
- Shimozono M, Oishi A, Hata M, et al. Restoration of the photoreceptor outer segment and visual outcomes after macular hole closure: spectral-domain optical coherence tomography analysis. Graefes Arch Clin Exp Ophthalmol 2011; 249: 1469-76.
- Itoh Y, Inoue M, Rii T, et al. Correlation between length of foveal cone outer segment tips line defect and visual acuity after macular hole closure. Ophthalmology 2012; 119: 1438-46.
- Wakabayashi T, Fujiwara M, Sakaguchi H, et al. Foveal microstructure and visual acuity in surgically closed macular holes: spectral-domain optical coherence tomographic analysis. Ophthalmology 2010; 117: 1815-24.
- Bottoni F, De Angelis S, Luccarelli S, et al. The dynamic healing process of idiopathic macular holes after surgical repair: a spectral-domain optical coherence tomography study. Invest Ophthalmol Vis Sci. 2011; 52: 4439-46.
- Kusuhara S, Teraoka Escaño MF, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol 2004; 138 (5): 709-16.
- Ruiz-Moreno JM, Staicu C, Piñero DP, et al. Optical coherence tomography predictive factors for macular hole surgery outcome. Br J Ophthalmol 2008; 92 (5): 640-4.
- Kumagai K, Ogino N, Hangai M, et al. Percentage of fellow eyes that develop full-thickness macular hole in patients with unilateral macular hole. Arch Ophthalmol 2012; 130: 393-4.
- Jackson TL, Nicod E, Angelis A, et al. Vitreous attachment in age-related macular degeneration, diabetic macular edema, and retinal vein occlusion: a systematic review and metaanalysis. Retina 2013; 33: 1099-108.
- Ophir A, Trevino A, Fatum S. Extrafoveal vitreous traction associated with diffuse diabetic macular oedema. Eye 2010; 24: 347-53.
- Chablani J, Khodani M, Hussein A, et al. Role of macular hole angle in macular hole closure. Br J Ophthalmol 2015; 99: 1634-8.
- Shukla SY, Afshar AR, Kiernan DF, et al. Outcomes of chronic macular hole surgical repair. Indian J Ophthalmol 2014; 62: 795-8.
- Rahimy E, McCannel CA. Impact of internal limiting membrane peeling on macular hole reopening: A systematic review and meta-analysis. Retina 2016; 36: 679-87.
- Geng XY, Wu HQ, Jiang JH, et al. Area and volume ratios for prediction of visual outcome in idiopathic macular hole. Int J Ophthalmol 2017; 10 (8): 1255-60.
- Chalam KV, Murthy RK, Gupta SK, et al. Foveal structure defined by spectral domain optical coherence tomography correlates with visual function after macular hole surgery. Eur J Ophthalmol 2010; 20: 572-7.
- Chang LK, Koizumi H, Spaide RF. Disruption of the photoreceptor inner segment-outer segment junction in eyes with macular holes. Retina 2008; 28: 969-75.
- Baba T, Yamamoto S, Arai M, et al. Correlation of visual recovery and presence of photoreceptor inner/outer segment junction in optical coherence images after successful macular hole repair. Retina 2008; 28: 453-8.
- Inoue M, Watanabe Y, Arakawa AC. Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes. Graefes Arch Clin Exp Ophthalmol 2009; 247: 325-30.
- Okamoto T, Shinoda H, Kurihara T, et al. Intraoperative and fluorescein angiographic findings of a secondary macular hole associated with age-related macular degeneration treated by pars plana vitrectomy. BMC Ophthalmology 2014; 14: 114-7.
- Baek S, Lee WJ, Park KH, et al. Health screening program revealed risk factors associated with development and progression of papillomacular bundle defect. EPMA Journal 2021; 12: 41-55.
- Ling L, Liu Y, Zhou B, et al. Inverted internal limiting membrane flap technique versus internal limiting membrane peeling for vitrectomy in highly myopic eyes with macular hole-induced retinal detachment: an updated meta-analysis. Hindawi Journal of Ophthalmology 2020;1-9.
- Yuan J, Zhang LL, Lu YJ, et al. Vitrectomy with internal limiting membrane peeling versus inverted internal limiting membrane flap technique for macular hole-induced retinal detachment. A systemic review of literature and meta-analysis. BMC Ophthalmology 2017; 17: 219.
- Theodossiadis PG, Grigoropoulos VG, Theodossiadis GP. The significance of the external limiting membrane in the recovery of photoreceptor layer after successful macular hole closure: a study by spectral domain optical coherence tomography. Ophthalmologica 2011; 225: 176-84.
- Kaz´mierczak K, Stafiej J , Stachura J, et al. Long-Term Anatomic and Functional Outcomes after Macular Hole Surgery. Hindawi Journal of Ophthalmology 2018; 1: 1-9.
- Vaziri K, Schwartz SG, Kishor KS, et al. Rates of Reoperation and Retinal Detachment Following Macular Hole Surgery. Ophthalmology 2016; 123 (1): 26-31.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Eylül 2022 |
| Gönderilme Tarihi | 9 Haziran 2022 |
| Yayımlandığı Sayı | Yıl 2022 |