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Gupta M, Lean J. Full-Thickness Macular Hole Caused by Acute Subretinal Hemorrhage From Wet Age-Related Macular Degeneration. JOURNAL OF VITREORETINAL DISEASES 2024; 8:82-85. [PMID: 38223780 PMCID: PMC10786074 DOI: 10.1177/24741264231206281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Purpose: To present a case of full-thickness macular hole (MH) that developed in association with acute subretinal hemorrhage from wet age-related macular degeneration (AMD). Methods: A retrospective observational review of a single case was performed. Results: An 84-year-old man with wet AMD presented with central vision loss and floaters and was noted to have a subretinal hemorrhage and an associated MH, which subsequently progressed to MH-associated macular detachment. The patient had a pars plana vitrectomy with internal limiting membrane peeling, gas tamponade, and prone positioning, resulting in closure of the MH and improvement in visual acuity. Conclusions: A full-thickness MH developed as a result of foveal dehiscence from an acute hemorrhage caused by choroidal neovascularization in wet AMD.
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Affiliation(s)
- Mrinali Gupta
- Retina Associates of Orange County, Laguna Hills, CA, USA
| | - John Lean
- Retina Associates of Orange County, Laguna Hills, CA, USA
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Tarkova A, Hejsek L, Jurecka T, Wolkova P, Rubesova M, Hackl M. Pars plana vitrectomy for vitreoretinal interface disorders coincident with intermediate stage age-related macular degeneration. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:366-369. [PMID: 36472168 DOI: 10.5507/bp.2022.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND AIMS Currently around 67 million people in Europe are affected by some form of age-related macular degeneration (AMD). As most known types of vitreoretinal (VR) interface disorders can coexist with AMD and as we can favourably affect the former with vitreoretinal surgery, our goal was to evaluate the results of vitreoretinal interface disorder surgery with macular peeling in relation to coincident intermediate stage AMD. METHODOLOGY This was a retrospective evaluation of eyes operated with 25-gauge pars plana vitrectomy (PPV). The monitored parameters were anatomical and functional findings and, safety of the procedure. The surface of the macula was stained with trypan blue and treated (peeling) with a disposable microforceps. 10% perfluoropropane, or the air tamponade was used. Distance visual acuity was examined on the ETDRS chart, the macular finding was monitored by OCT and photodocumented. The post-operative face-down position was 3-5 days. The follow-up period was 6 months. RESULTS 17 eyes (14 patients, woman 86%) mean age 74 years. The primary indications for the procedure were: idiopathic macular hole (IMD) 59%, epiretinal membrane 29% and vitreomacular traction syndrome 12%. Ophthalmoscopic and OCT findings of intermediate dry form of AMD (100%), in 24% was drusoid ablation of the pigment leaf. In all cases of IMD, primary closure occurred. Input visual acuity 0.1-0.6 improved to 0.2-0.9 at the end of the follow-up period (P<0.05). No complications during surgery or progression of AMD in the follow-up period were observed. CONCLUSION PPV for vitreoretinal interface disorders have similar anatomical results, whether the outer part of the retina is disrupted by intermediate AMD or not. Functional results are affected by possible disruption of the RPE or the outer layers of the neuroretina by AMD. The PPV procedure has a standard security profile. It is safe and does not affect the progression of AMD in the short term.
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Affiliation(s)
- Anna Tarkova
- Faculty Hospital Nitra, Spitalska 6, Nitra, Slovak Republic
| | - Libor Hejsek
- Eye Clinic, Lexum, Prague, Czech Republic
- Department of Ophthalmology, 3rd Faculty of Medicine, Charles University and Hospital Kralovske Vinohrady, Prague, Czech Republic
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Wakabayashi T, Shiraki N, Tsuboi K, Oshima Y, Abe K, Yamamoto Y, Hisashi F, Baba K, Ishida Y, Otsuka Y, Shiraki A, Suzue M, Hashimoto R, Venkatesh R, Chhablani J, Gomi F, Kamei M, Maeno T, Regillo CD, Yonekawa Y, Ikuno Y. Risk Factors and Outcomes of Postoperative Macular Hole Formation after Vitrectomy for Myopic Traction Maculopathy: SCHISIS Report No. 2. Ophthalmol Retina 2023; 7:779-787. [PMID: 37257585 DOI: 10.1016/j.oret.2023.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE To evaluate the incidence, pathogenesis, risk factors, and treatment outcomes of postoperative macular hole (MH) after pars plana vitrectomy (PPV) for myopic traction maculopathy (MTM). DESIGN Multicenter, interventional, retrospective case series. SUBJECTS Consecutive eyes that underwent PPV for MTM with a minimum 6-month follow-up. METHODS We investigated the characteristics and treatment outcomes of postoperative MH after MTM surgery. MAIN OUTCOME MEASURES Incidence, risk factors, and anatomic and visual outcomes of postoperative MH. RESULTS We included 207 eyes (207 patients) with a mean follow-up of 25.9 months. During follow-up, 24 (11.6%) eyes developed MH (10 with concurrent MH retinal detachment); 15 eyes within 30 days (early), 4 eyes between 31 and 180 days (intermediate), and 5 eyes after 180 days (late). Logistic regression analysis revealed male gender (odds ratio [OR], 2.917; 95% confidence interval [CI], 1.198-7.100; P = 0.018), thinner preoperative choroidal thickness (OR, 0.988; 95% CI, 0.976-1.000; P = 0.048), and use of indocyanine green for internal limiting membrane peeling (OR, 2.960; 95% CI, 1.172-7.476; P = 0.022) as significant risk factors for postoperative MH. Internal limiting membrane peeling with a fovea-sparing technique tended to protect against postoperative MH, but it was not statistically significant (P = 0.096), because 1 eye still developed MH. Postoperative MHs were treated by observation (6 eyes), in-office octafluoropropane (C3F8) gas injection (7 eyes), or PPV (11 eyes). Macular hole closure was achieved in 20 eyes (83%). The hole closure rate was 67% (4/6 eyes) after observation, 71% (5/7 eyes) after C3F8 gas injection, and 91% (10/11 eyes) after PPV. However, visual outcomes were significantly worse for eyes with postoperative MH than those without (0.38 ± 0.43 vs. 0.68 ± 0.46; P = 0.002). CONCLUSIONS Postoperative MH may occur in 11.6% of patients with MTM at any time after surgery. Retreatment resulted in relatively favorable anatomic closure but unfavorable visual outcomes. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Taku Wakabayashi
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | - Nobuhiko Shiraki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kotaro Tsuboi
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan; Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Yusuke Oshima
- Oshima Eye Clinic, Seiyukai Medical Corporation, Takatsuki, Osaka, Japan
| | - Kentaro Abe
- Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Japan
| | - Yuki Yamamoto
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Fukuyama Hisashi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Keita Baba
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yuichiro Ishida
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yuki Otsuka
- Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Japan
| | - Akihiko Shiraki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masaki Suzue
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ryuya Hashimoto
- Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Japan
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Rajaji Nagar, Bengaluru, Karnataka, India
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh Eye Center, Pittsburgh, Pennsylvania
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Motohiro Kamei
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Takatoshi Maeno
- Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Japan
| | - Carl D Regillo
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Yoshihiro Yonekawa
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
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Chan CK, Mein CE, Glassman AR, Beaulieu WT, Calhoun CT, Jaffe GJ, Jampol LM, MacCumber MW, Maguire MG, Maturi RK, Salehi-Had H, Rofagha S, Sun JK, Martin DF. Pneumatic Vitreolysis with Perfluoropropane for Vitreomacular Traction with and without Macular Hole: DRCR Retina Network Protocols AG and AH. Ophthalmology 2021; 128:1592-1603. [PMID: 33989683 PMCID: PMC8545749 DOI: 10.1016/j.ophtha.2021.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate pneumatic vitreolysis (PVL) in eyes with vitreomacular traction (VMT) with and without full-thickness macular hole (FTMH). DESIGN Two multicenter (28 sites) studies: a randomized clinical trial comparing PVL with observation (sham injection) for VMT without FTMH (Protocol AG) and a single-arm study assessing PVL for FTMH (Protocol AH). PARTICIPANTS Participants were adults with central VMT (vitreomacular adhesion was ≤3000 μm). In Protocol AG, visual acuity (VA) was 20/32 to 20/400. In Protocol AH, eyes had a FTMH (≤250 μm at the narrowest point) and VA of 20/25 to 20/400. METHODS Pneumatic vitreolysis using perfluoropropane (C3F8) gas. MAIN OUTCOME MEASURES Central VMT release at 24 weeks (Protocol AG) and FTMH closure at 8 weeks (Protocol AH). RESULTS From October 2018 through February 2020, 46 participants were enrolled in Protocol AG, and 35 were enrolled in Protocol AH. Higher than expected rates of retinal detachment and tear resulted in early termination of both protocols. Combining studies, 7 of 59 eyes (12% [95% CI, 6%-23%]; 2 eyes in Protocol AG, 5 eyes in Protocol AH) that received PVL developed rhegmatogenous retinal detachment (n = 6) or retinal tear (n = 1). At 24 weeks in Protocol AG, 18 of 23 eyes in the PVL group (78%) versus 2 of 22 eyes in the sham group (9%) achieved central VMT release without rescue vitrectomy (adjusted risk difference, 66% [95% CI, 44%-88%]; P< 0.001). The mean change in VA from baseline at 24 weeks was 6.7 letters in the PVL group and 6.1 letters in the sham group (adjusted difference, -0.8 [95% CI, -6.1 to 4.5]; P = 0.77). In Protocol AH, 10 of 35 eyes (29% [95% CI, 16%-45%]) achieved FTMH closure without rescue vitrectomy at 8 weeks. The mean change in VA from baseline at 8 weeks was -1.5 letters (95% CI, -10.3 to 7.3 letters). CONCLUSIONS In most eyes with VMT, PVL induced hyaloid release. In eyes with FTMH, PVL resulted in hole closure in approximately one third of eyes. These studies were terminated early because of safety concerns related to retinal detachments and retinal tears.
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Affiliation(s)
- Clement K Chan
- Southern California Desert Retina Consultants, Palm Desert, California
| | - Calvin E Mein
- Retinal Consultants of San Antonio, San Antonio, Texas
| | | | | | | | - Glenn J Jaffe
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Lee M Jampol
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Maureen G Maguire
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Hani Salehi-Had
- Retina Associates of Southern California, Huntington Beach, California
| | - Soraya Rofagha
- East Bay Retina Consultants, Oakland, California, and Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Jennifer K Sun
- Joslin Diabetes Center, Beetham Eye Institute, Department of Ophthalmology, Harvard University, Boston, Massachusetts
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FULL-THICKNESS MACULAR HOLE IN AGE-RELATED MACULAR DEGENERATION PATIENTS WITH TWO DISTINCT ENTITIES: A Multicenter Study. Retina 2021; 41:2066-2072. [PMID: 34310095 DOI: 10.1097/iae.0000000000003141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe optical coherence tomography characteristics of full-thickness macular holes (FTMHs) in age-related macular degeneration patients. METHODS A multicenter, retrospective, observational case series of patients diagnosed with age-related macular degeneration and FTMHs seen between January 1, 2009, and January 3, 2020. Clinical charts and spectral-domain optical coherence tomography images were reviewed. Optical coherence tomography findings included FTMH-inverted trapezoid or hourglass appearance, central macular thickness (CMT), complete retinal pigment epithelium and complete retinal outer retinal atrophy, and presence of pigment epithelium detachment and epiretinal membrane. The mean outcome was the morphologic and functional characterization of different subtypes of FTMHs. RESULTS A total of 86 eyes of 85 consecutive patients, with mean age of 80.31 ± 8.06 and mean best-corrected visual acuity of 1.17 ± 0.58 logarithm of the minimal angle of resolution. Two different subtypes of FTMHs were identified: tractional and degenerative. Fifty (58%) degenerative FTMHs characterized with inverted trapezoid appearance and 36 (42%) tractional FTMHs characterized with hourglass appearance. Degenerative FTMHs presented with 66% of CMT < 240 µm, 14% of CMT > 320, and 70% of complete retinal outer retinal atrophy, in comparison with 41% of CMT < 240 µm, 42.9% of CMT > 320%, and 20% of complete retinal outer retinal atrophy in the tractional FTMH group (P = 0.002, 0.003, <0.001, respectively). The presence of epiretinal membrane and pigment epithelium detachment where significantly higher in tractional FTMHs (P = 0.02, 0.03, respectively). CONCLUSION Degenerative and tractional FTMHs may be two distinct clinical entities. Discerning degenerative from tractional FTMHs is possible by using optical coherence tomography features including shape of the FTMHs, CMT, internal-external ratio of FTMHs, and presence of complete retinal outer retinal atrophy, pigment epithelium detachment, and epiretinal membrane.
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MACULAR HOLE ASSOCIATED WITH AGE-RELATED MACULAR DEGENERATION: Pathogenesis and Surgical Outcomes. Retina 2021; 41:2079-2087. [PMID: 34543242 DOI: 10.1097/iae.0000000000003148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To ascertain the pathogenesis of macular hole (MH) associated with age-related macular degeneration (AMD) and its surgical outcomes. METHODS Patients with full-thickness MH associated with AMD (higher grades than intermediate) were enrolled. The mechanism of MH formation and closure rate after vitrectomy (surgical outcome) were determined using optical coherence tomography imaging. RESULTS The mechanism of MH formation (35 eyes) associated with AMD was classified into four types: vitreomacular traction (42.9%), gradual retinal thinning caused by subretinal drusen or pigment epithelial detachment (22.9%), massive subretinal hemorrhage (20.0%), and combined (14.3%). In the 41 eyes that underwent vitrectomy, the logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.82 (0.10-2.30) preoperative to 0.69 (0.10-2.30) postoperative (P = 0.001). Successful closure of the MH was achieved in 33 eyes (80.5%) after vitrectomy. No significant association was observed between the closure rate of MH after vitrectomy and mechanism of MH formation (P = 0.083). CONCLUSION The mechanism of MH formation associated with AMD was classified into four types and was not related to its surgical outcome. Considering visual improvement and surgical outcome after vitrectomy in our study, active surgical treatment can be considered for MH associated with AMD.
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Kayaarasi Ozturker Z, Akca Bayar S, Yaman Pinarci E, Kurt RA, Akkoyun I, Yilmaz G. Atypical macular hole formation after Anti-VEGF therapy for neovascular age-related macular degeneration: Coincidence or consequence? ARCHIVOS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGÍA 2021; 96:455-461. [PMID: 34479701 DOI: 10.1016/j.oftale.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/07/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND OBJECTIVES Age-related macular degeneration (AMD) is the primary cause of blindness in developed countries, particularly in older adults. Anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection is the current standard treatment for neovascular form of AMD. Studies reporting macular hole (MH) formation following anti-VEGF treatment are limited, and the exact pathogenesis is still under discussion. With the present study, we aim to analyse the clinical features of eyes developing MH after anti-VEGF therapy for neovascular AMD. MATERIALS AND METHODS Patients were treated with intravitreal anti-VEGF agents for at least one year and stable for at least six months. Best-corrected visual acuity (BCVA) and optical coherence tomography findings were evaluated. RESULTS Nineteen eyes of 18 patients were included in this study. Patients had an average age of 77.7 years at first visit and eight were female. The average number of injections before the MH formation was four. MH developed after a mean follow-up of 5.1 months after the last injection. Sixteen eyes had (84.2%) had choroidal neovascular membrane without any abnormal vitreomacular traction. Eleven eyes (57.8%) had retinal pigment epithelium detachment (PED), two (10.5%) had an epiretinal membrane (ERM), and one (5.2%) had retinal pigment epithelium (RPE) tear. The mean first and last BCVA was 1.07±0.48 LogMAR (0.3-1.8) and 1.16±0.38 logMAR (0.4-1.8), respectively. CONCLUSIONS A macular hole can be observed in AMD patients receiving anti-VEGF therapy. Increased fibrovascular scar tissue due to subretinal fluid resolution, neovascular membrane contraction, and the presence of PED, RPE tear, and ERM may contribute to MH formation.
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Affiliation(s)
- Z Kayaarasi Ozturker
- Baskent University, Faculty of Medicine, Department of Ophthalmology, Istanbul Hospital, Estambul, Turkey.
| | - S Akca Bayar
- Baskent University, Faculty of Medicine, Department of Ophthalmology, Ankara Hospital, Ankara, Turkey
| | - E Yaman Pinarci
- Baskent University, Faculty of Medicine, Department of Ophthalmology, Istanbul Hospital, Estambul, Turkey
| | - R A Kurt
- Baskent University, Faculty of Medicine, Department of Ophthalmology, Istanbul Hospital, Estambul, Turkey
| | - I Akkoyun
- Baskent University, Faculty of Medicine, Department of Ophthalmology, Ankara Hospital, Ankara, Turkey
| | - G Yilmaz
- Baskent University, Faculty of Medicine, Department of Ophthalmology, Ankara Hospital, Ankara, Turkey
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Sonmez K. Autologous neurosensory retinal transplantation for large refractory idiopathic macular hole. Int Ophthalmol 2021; 41:1415-1425. [PMID: 33475907 DOI: 10.1007/s10792-021-01716-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the structural and functional reconstruction of the macula after autologous neurosensory retinal-free flap transplantation (ANRFFT) in eyes with large refractory idiopathic macular holes (IMHs). METHODS Patients with refractory IMHs after multiple surgeries who underwent ANRFFT were retrospectively reviewed. The main outcomes were anatomic closure of MH, change in external limiting membrane (ELM) defect on optical coherence tomography (OCT) and best-corrected visual acuity (BCVA). RESULTS A total of 7 patients (4 female and 3 male; mean age 60.6 ± 8.6 years) were included in the study. Mean preoperative largest basal diameter was 1146.7 ± 413.7 µm (range, 653-1768 µm), and mean narrowest inner-opening diameter was 788.9 ± 148.8 µm (range, 644-1100 µm). Mean BCVA (logarithm of the minimum angle of resolution [logMAR]) significantly improved from 1.53 ± 0.16 (range, 1.3-1.7) to 0.89 ± 0.23 (range, 0.6-1.3) at the final follow-up (P < 0.001). OCT revealed complete closure of MH in all eyes. Mean preoperative ELM defect significantly decreased from 1450.3 ± 306.5 µm (range, 1044-1908 mm) to 533.1 ± 399.2 µm (range, 0-1156 µm, P = 0.001). Postoperative complications included retinal detachment (n = 1), cystoid macular edema like changes in the graft (n = 1) and reactive pigment epithelial hyperplasia (n = 1). CONCLUSION Although some postoperative complications did occur, ANRFFT seems to be an effective treatment for large refractory IMHs, and can promote recovery of the outer retinal structure resulting in functional improvement.
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Affiliation(s)
- Kenan Sonmez
- Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Kale Mh. Ulucanlar Cd. No: 59, Altındag, 06250, Ankara, Turkey.
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Amram AL, Mandviwala MM, Ou WC, Wykoff CC, Shah AR. Predictors of Visual Acuity Outcomes Following Vitrectomy for Idiopathic Macular Hole. Ophthalmic Surg Lasers Imaging Retina 2018; 49:566-570. [PMID: 30114300 DOI: 10.3928/23258160-20180803-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 11/02/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate predictors of visual outcomes in patients who underwent vitrectomy for full-thickness macular hole (FTMH) with at least 1 year of follow-up. PATIENTS AND METHODS Retrospective, noncomparative, consecutive case series of 132 eyes of 122 patients who underwent surgical repair of idiopathic FTMH with at least 1 year of follow-up. Predictors of visual acuity (VA) outcomes were analyzed using linear regression. RESULTS Mean follow-up time was 22.2 months. Twenty-three eyes (17.4%) had age-related macular degeneration (AMD), of which 17 (73.9%) cases were mild and nonexudative. At final follow-up, poor preoperative VA (P < .001), perioperative complications (P < .001), AMD (P < .001), and delay from preoperative evaluation to surgery (P = .037) were significant predictors of final VA. In multiple regression, these variables remained significant (P < .001, P = .011, P < .001, and P = .002, respectively). CONCLUSION Poor preoperative VA, perioperative complications, AMD, and delay to surgery were significant predictors of final VA following FTMH repair. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:566-570.].
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