Retreatment of full-thickness macular hole: predictive value of optical coherence tomography

Hillenkamp, Jost; Kraus, Jürgen; Framme, Carsten; Jackson, Timothy L.; Roider, Johann; Gabel, Virginie; Sachs, Helmut

doi:10.1136/bjo.2007.115642

Cited by 83 publications

(84 citation statements)

References 23 publications

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“…Consistent with findings of Hillenkamp et al [11] , we found that the diameter of the MH before primary vitrectomy as well as before revitrectomy did not influence the closure rate after revitrectomy. Nevertheless, subgroup analysis revealed that the mean diameter of the MHs that persisted even after the revitrectomy had significantly increased after first surgery.…”

Section: Morphological Aspectssupporting

confidence: 82%

“…We achieved a final closure rate of 85% (52/61 eyes) after the use of APC. This compares to Hillenkamp et al [11] who report a final closure rate of 77% (17/22 eyes) after revitrectomy with APC compared to only 40% (2/5 eyes) after revitrectomy without this adjuvant. However, this study was rather small and 9 of the patients with APC got an oil endotamponade which hinders comparability.…”

Section: Mh Closure Ratesmentioning

confidence: 54%

“…These persistent MHs have a poor visual outcome. Strategies to treat these persistent MHs include revitrectomy with gas [6,7] , use of heavy silicone oil [8][9][10] , application of autologous platelet concentrate (APC) or serum [11][12][13][14] , and most recently ILM or lens capsule flap translocation [15,16] or surgical induction of macular detachment [17] . The usefulness of these different methods and healing adjuvants still remains controversial and studies are often small, have a rather short follow-up or lack optical coherencewith revitrectomy with gas plus APC or whole blood (WB).…”

Section: Introductionmentioning

confidence: 99%

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Persistent Full-Thickness Idiopathic Macular Hole: Anatomical and Functional Outcome of Revitrectomy with Autologous Platelet Concentrate or Autologous Whole Blood

Purtskhvanidze¹,

Frühsorger²,

Bartsch³

et al. 2017

Ophthalmologica

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Purpose: To evaluate long-term outcome after revitrectomy with autologous platelet concentrate (APC) or whole blood (WB) in persistent idiopathic macular hole (MH) after vitrectomy with internal limiting membrane (ILM) peeling. Procedures: Retrospective study of 75 eyes with persistent MH after vitrectomy with ILM peeling and gas. All patients underwent revitrectomy with gas and APC (n = 61) or WB (n = 14). Main outcome measures were anatomical closure rate and postoperative best-corrected visual acuity (BCVA). Results: Closure rate after revitrectomy was 85.2% (52/61) in the APC group and 7.1% (1/14) in the WB group. Median follow-up was 58 (range 3-147) months. Median BCVA (logMAR) in patients with finally closed MHs was 0.4 ± 0.3. Patients with defects of the ellipsoid zone had significantly worse postoperative BCVA. Morphological MH configuration (atrophic or elevated edges) did not correlate with final closure rate. Conclusions: Revitrectomy with APC and gas is a very effective treatment in persistent MH after vitrectomy with ILM peeling and gas.

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Section: Morphological Aspectssupporting

confidence: 82%

Section: Mh Closure Ratesmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

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Persistent Full-Thickness Idiopathic Macular Hole: Anatomical and Functional Outcome of Revitrectomy with Autologous Platelet Concentrate or Autologous Whole Blood

Purtskhvanidze¹,

Frühsorger²,

Bartsch³

et al. 2017

Ophthalmologica

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“…Clinically relevant vitreomacular adhesions, macular holes, and pseudoholes have been documented by conventional time domain OCT [70,95,96,97,98]. A posterior hyaloid membrane is seen in 57% of patients with idiopathic macular holes on OCT but is detected biomicroscopically in less than half of these patients [99,100,101].…”

Section: Clinical Assessmentmentioning

confidence: 99%

The Vitreous, the Retinal Interface in Ocular Health and Disease

2013

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The vitreous is a complex structure whose composition and appearance change with age. Anomalous adhesions between the posterior vitreous face and the retinal surface are the cause of numerous vitreoretinal complications, while the presence of an intact posterior hyaloid provides a scaffold for vascular growth and anteroposterior traction. This review summarizes what is known about the biochemistry of the vitreous, the process of posterior vitreous detachment (PVD) development, and the available clinical approaches to examining the vitreous and its interface. A pooled analysis of studies looking at the presence of a complete, partial or absent PVD in a number of macular and retinal diseases allows us to establish odds ratios for these various states. From this emerge both protective and disease-associated states in conditions such as proliferative diabetic retinopathy, macular edema, and age-related macular degeneration. With the emergence of pharmacological means to separate the posterior hyaloid, a better understanding of the possible role of the vitreous in tractional syndromes is required.

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“…OCT helps in diagnosing and classification of the macular holes. The determined size and configuration by OCT helps predicting the surgery outcomes [95,96]. It allows evaluation of the vitreoretinal interface in epiretinal membrane and vitreoretinal traction [97].…”

Section: Optical Coherence Tomography (Oct)mentioning

confidence: 99%