Preoperative prognostic factors for macular hole surgery: Which is better?

Unsal, Erkan; Çubuk, Mehmet Özgür; Ciftci, Furkan

doi:10.4103/ojo.ojo_247_2017

Cited by 13 publications

(4 citation statements)

References 23 publications

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“…While recent advances in MH surgery have improved the rate of anatomical closure, visual outcomes remain suboptimal in some patients [13][14][15]. Vitreoretinal surgeons have thus focused their attention on factors that may improve visual outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Visual Outcomes in Closed Idiopathic Macular Holes after Vitrectomy: Outcomes at 4 Years in a Monocentric Study

Lachance

Hébert

You

et al. 2022

Journal of Ophthalmology

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Purpose. To identify predictive factors of visual outcomes in the eyes after successful macular hole (MH) surgery. Methods. It is a retrospective monocentric study of the eyes that underwent successful vitrectomy for full-thickness MH in an academic, tertiary care center (CHU de Québec–Université Laval, Québec, Canada) between 2014 and 2018. We included a single eye per patient and excluded the eyes with ocular comorbidities. Clinical and anatomical features of patients were collected, including demographics, MH duration, baseline MH size, baseline visual acuity (VA), and final VA. Multiple logistic regressions were performed to determine predictive factors of VA ≥70 ETDRS letters (Snellen equivalent: 20/40) and VA gain ≥15 ETDRS letters at final follow-up. Areas under the receiver operating characteristic curve (AUC) were used to determine the performance of each model and identify the Youden index maximizing performance at a given threshold. Results. A total of 460 eyes were included in this study; 274/460 eyes (60%) achieved final VA ≥70 ETDRS letters and 304/460 eyes (66%) had a VA gain ≥15 ETDRS letters at 24 months follow-up. Multiple logistic regression analyses showed that the main predictive factors for final VA ≥70 ETDRS letters (model AUC = 0.716) were baseline VA (OR = 1.064; p < 0.001 ), MH duration (OR = 0.950; p = 0.005 ), and age (OR = 0.954; p = 0.004 ). Predictors of VA gain ≥15 ETDRS letters at final follow-up (model AUC = 0.615) were baseline VA (OR = 0.878; p < 0.001 ), MH duration (OR = 0.940; p < 0.001 ), and MH size (OR = 0.998; p = 0.036 ). Thresholds for the final VA ≥70 ETDRS letters model and the VA gain ≥15 ETDRS letters model were VA ≥55.5 ETDRS letters (Snellen equivalent: 6/30) and MH size of 237 μm, respectively. Conclusion. The eyes with shorter MH duration, smaller MH size, and higher preoperative VA achieved better visual outcomes after successful MH surgery.

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Visual Outcomes in Closed Idiopathic Macular Holes after Vitrectomy: Outcomes at 4 Years in a Monocentric Study

Lachance

Hébert

You

et al. 2022

Journal of Ophthalmology

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“…ERMs etiology is idiopathic in many cases (80%) or secondary to different situations, including retinal detachment or vascular or inflammatory retinal diseases ( Bottós et al, 2012 ). Prognostic and therapeutic decisions occur principally by OCT evaluation ( Unsal et al, 2019 ). Vitrectomy followed by ERM peel-off is the routine surgical approach.…”

Section: Retinal Diseases: the Mechanisms Behind Clinical Manifestatimentioning

confidence: 99%

Biomarkers of Neurodegeneration and Precision Therapy in Retinal Disease

et al. 2021

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Vision-threatening retinal diseases affect millions of people worldwide, representing an important public health issue (high social cost) for both technologically advanced and new-industrialized countries. Overall RD group comprises the retinitis pigmentosa, the age-related macular degeneration (AMD), the diabetic retinopathy (DR), and idiopathic epiretinal membrane formation. Endocrine, metabolic, and even lifestyles risk factors have been reported for these age-linked conditions that represent a “public priority” also in this COVID-19 emergency. Chronic inflammation and neurodegeneration characterize the disease evolution, with a consistent vitreoretinal interface impairment. As the vitreous chamber is significantly involved, the latest diagnostic technologies of imaging (retina) and biomarker detection (vitreous) have provided a huge input at both medical and surgical levels. Complement activation and immune cell recruitment/infiltration as well as detrimental intra/extracellular deposits occur in association with a reactive gliosis. The cell/tissue aging route shows a specific signal path and biomolecular profile characterized by the increased expression of several glial-derived mediators, including angiogenic/angiostatic, neurogenic, and stress-related factors (oxidative stress metabolites, inflammation, and even amyloid formation). The possibility to access vitreous chamber by collecting vitreous reflux during intravitreal injection or obtaining vitreous biopsy during a vitrectomy represents a step forward for an individualized therapy. As drug response and protein signature appear unique in each single patient, therapies should be individualized. This review addresses the current knowledge about biomarkers and pharmacological targets in these vitreoretinal diseases. As vitreous fluids might reflect the early stages of retinal sufferance and/or late stages of neurodegeneration, the possibility to modulate intravitreal levels of growth factors, in combination to anti-VEGF therapy, would open to a personalized therapy of retinal diseases.

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“…If the individual has a symptomatic MH, surgery is recommended. Pars plana vitrectomy (PPV), the removal of cortical vitreous and epiretinal membranes, and face-down intraocular gas tamponade, is the treatment of choice (3) . The most used gases are perfluoropropane (C 3 F 8 ) and sulfur hexafluoride (SF 6 ) which have similar efficacy (4) .…”

Section: Introductionmentioning

confidence: 99%

Influence of the dilution method on the intraocular duration of C3F8 in vitrectomy for macular hole: a randomized clinical trial

Pinto,

Soares,

Costa

et al. 2024

ABO

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To compare the injection of small amounts of undiluted C 3 F 8 with the traditional gas injection in vitrectomy for macular hole treatment. Methods: This clinical trial included 26 individuals divided into two groups. Group 1 received an intravitreal injection of 0.9-1.0 mL of 100% C 3 F 8 , and Group 2 received 15-20 mL of 20% C 3 F 8 . Results: The median intraocular gas duration was 31 days in Group 1 and 34 in Group 2. The median letter gains in corrected distance visual acuity for the 26 th postoperative week were 20 letters in Group 1 and 12.5 in Group 2. The median intraocular pressure was normal in both groups. Primary anatomical success was 11/13 in both groups. Conclusions: The use of C 3 F 8 gas in a small undiluted volume is an alternative that slightly reduces the duration of the gas without negatively affecting the anatomical and visual response.

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Preoperative prognostic factors for macular hole surgery: Which is better?

Cited by 13 publications

References 23 publications

Prognostic Factors for Visual Outcomes in Closed Idiopathic Macular Holes after Vitrectomy: Outcomes at 4 Years in a Monocentric Study

Prognostic Factors for Visual Outcomes in Closed Idiopathic Macular Holes after Vitrectomy: Outcomes at 4 Years in a Monocentric Study

Biomarkers of Neurodegeneration and Precision Therapy in Retinal Disease

Influence of the dilution method on the intraocular duration of C3F8 in vitrectomy for macular hole: a randomized clinical trial

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