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Hanai M, Amaral DC, Jacometti R, Aguiar EHC, Gomes FC, Cyrino LG, Alves MR, Monteiro MLR, Fuganti RM, Casella AMB, Louzada RN. Large macular hole and autologous retinal transplantation: a systematic review and meta-analysis. Int J Retina Vitreous 2024; 10:56. [PMID: 39175026 PMCID: PMC11340077 DOI: 10.1186/s40942-024-00573-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION Macular holes are breaks in the retinal tissue at the center of the macula, affecting central vision. The standard treatment involves vitrectomy with membrane peeling and gas tamponade. However, for larger or chronic holes, alternative techniques like autologous retinal graft have emerged. This meta-analysis evaluates the efficacy and safety of retinal transplantation in managing large macular holes. METHODS We conducted a systematic review and meta-analysis following PRISMA guidelines. The study was prospectively registered in PROSPERO (CRD42024504801). We searched PubMed, Web of Science, Cochrane, and Embase databases for observational studies including individuals with large macular holes with or without retinal detachments and retinal transplantation as the main therapy. We used a random-effects model to compute the mean difference with 95% confidence intervals and performed statistical analysis using R software. RESULTS We conducted a comprehensive analysis of 19 studies involving 322 patients diagnosed with various types of macular holes (MHs). These included cohorts with refractory MH, high myopia associated with MH, primary MH, and MH with retinal detachment (RD). The findings were promising, revealing an overall closure rate of 94% of cases (95% CI 88-98, I2 = 20%). Moreover, there was a significant improvement in postoperative visual acuity across all subgroups, averaging 0.45 (95% CI 0.33-0.58 ; I2 = 72%; p < 0.01) overall. However, complications occurred with an overall incidence rate of 15% (95% CI 7-25; I2 = 59%). CONCLUSION ART for large MH shows promising results, including significant improvements in visual acuity and a high rate of MH closure with low complication risks overall and for subgroups.
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Affiliation(s)
- Mário Hanai
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Dillan Cunha Amaral
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Raiza Jacometti
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Laura Goldfarb Cyrino
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Milton Ruiz Alves
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Mário Luiz Ribeiro Monteiro
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Ricardo Noguera Louzada
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
- Instituto de Olhos São Sebastião, Largo do Machado 54, 1208, Rio de Janeiro, RJ, 22221-020, Brazil.
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Saxena S, Singh S, Meyer CH. Pathoanatomical aspects of macular hole closure: Emerging concepts. Indian J Ophthalmol 2024; 72:136-138. [PMID: 38131588 PMCID: PMC10841804 DOI: 10.4103/ijo.ijo_1763_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Sandeep Saxena
- Department of Ophthalmology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Samya Singh
- Department of Ophthalmology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Carsten H Meyer
- Department of Ophthalmology, Eye Centre Grischun, Chur, Switzerland, Augenklinik, Davos, Switzerland
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