Prognostic factors affecting macular hole closure types

Abstract

Purpose: In this study, we aimed to evaluate the relationship between macular hole closure types assessed by optical coherence tomography (OCT) and the preoperative prognostic factors. Materials and methods: In total, 183 patients who underwent pars plana vitrectomy and internal limiting membrane peeling for idiopathic macular hole between August 2014 and August 2019 were reviewed retrospectively. The preoperative measurements of the macular hole including minimum linear diameter (MLD), basal hole diameter (BHD) and hole height (HH) were measured on OCT images. The patients were divided into two closure types on the basis of postoperative OCT findings (type 1 closure: retinal edges were flat and there was no defect of the neurosensory retina on the fovea; type 2 closure: retinal edges were flat and there was a defect of the neurosensory retina on the fovea). The difference of prognostic factors such as age; duration of symptoms; preoperative best-corrected visual acuity (BCVA); preoperative macular hole measurements, including MLD, BHD and HH; and rate of reopening between two types were statistically analysed. Results: The mean age of patients was 66.33 ± 8.09 years (range: 48–88 years). According to OCT imaging, 117 eyes (63.9%) were classified into the type 1 closure group, and 66 eyes (36.1%) were classified into the type 2 closure group. There were no significant differences between two groups in age, duration of symptoms and preoperative BCVA ( p = 0.694, p = 0.092 and p = 0.15). MLD and BHD were significantly larger, and reopening was significantly more common in type 2 group ( p < 0.05, p = 0.04 and p < 0.005); however, there was no significant difference in HH between two groups ( p = 0.239). Conclusion: Preoperative horizontal measurements of macular hole may help to determine postoperative visual expectations and anatomical success, and predict the possibility of reopening.

Closure rate and recovery of subfoveal microstructures following conventional internal limiting membrane peeling versus per fluoro octane-assisted inverted flap for large macular holes – A randomized controlled trial (InFlap Study)

“…Also, the preoperative MH height was significantly higher in the InFlap group, which was purely by chance as the allocation was completely randomized. A recent study by Gümüş et al [ 20 ] did not find any significant influence on the closure rate by vertical MH measurements as compared to horizontal MH measurements.…”

Postoperative microstructural re-modelling and functional outcomes in idiopathic full thickness macular hole

“…In a retrospective study done by Demir et al . [ 18 ] on 183 patients, BD was 924.72 ± 341.58 mm (range: 118–2148) in eyes observed to have type-1 closure and 1153.58 ± 399.86 mm (range: 401–2303) with type-2 closure ( P = 0.04), and hole height was noted to be 464.5 ± 92.86 mm in type-1 closure and 506.67 ± 196.27 mm in type-2 closure ( P = 0.239).…”

Severe phimosis-like epiretinal membrane proliferation following internal limiting membrane peeling for macular hole

“…Yao et al [3] showed better visual and anatomical results with the 4-disc diameter peeling group compared to the 2-disc diameter group in macular holes less than 500 microns. The size of ILM peeled area was found to be a predictor in anatomical success of macular hole surgery [4] . ILM plays an important role as a scaffold for cellular proliferation and ERM formation [5] .…”