Factors predicting normal visual acuity following anatomically successful macular hole surgery.

Autor: Fallico M; Department of Ophthalmology, University of Catania, Catania, Italy., Jackson TL; Department of Ophthalmology, King's College Hospital, King's College London, London, UK., Chronopoulos A; Department of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen am Rhein, Germany., Hattenbach LO; Department of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen am Rhein, Germany., Longo A; Department of Ophthalmology, University of Catania, Catania, Italy., Bonfiglio V; Department of Ophthalmology, University of Catania, Catania, Italy., Russo A; Department of Ophthalmology, University of Catania, Catania, Italy., Avitabile T; Department of Ophthalmology, University of Catania, Catania, Italy., Parisi F; Department of Ophthalmology, University of Catania, Catania, Italy., Romano M; Department of Ophthalmology, Gavazzeni - Castelli Hospital, Humanitas University, Rozzano, Italy., Fiore T; Division of Ophthalmology, Department of Surgery and Biomedical Science, S Maria della Misericordia Hospital, University of Perugia, Perugia, Italy., Cagini C; Division of Ophthalmology, Department of Surgery and Biomedical Science, S Maria della Misericordia Hospital, University of Perugia, Perugia, Italy., Lupidi M; Division of Ophthalmology, Department of Surgery and Biomedical Science, S Maria della Misericordia Hospital, University of Perugia, Perugia, Italy., Frisina R; Department of Ophthalmology, University of Padova, Padova, Italy., Motta L; Department of Ophthalmology, King's College Hospital, King's College London, London, UK., Rejdak R; Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland., Nowomiejska K; Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland., Toro M; Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland., Ventre L; Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy., Reibaldi M; Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2021 May; Vol. 99 (3), pp. e324-e329. Date of Electronic Publication: 2020 Aug 24.
DOI: 10.1111/aos.14575
Abstrakt: Purpose: To assess the incidence of normal vision following anatomically successful macular hole surgery and associated clinical variables.
Methods: Multicentre, retrospective chart review. Preoperative, intraoperative and postoperative clinical data were extracted from electronic medical records from seven European vitreoretinal units. Inclusion criteria were as follows: eyes undergoing primary vitrectomy for idiopathic full-thickness macular hole from January 2015 to January 2018; postoperative macular hole closure confirmed by spectral domain optical coherence tomography (OCT); preoperative pseudophakia or phakic eyes receiving combined cataract surgery; one-year follow-up. The primary outcome was 'normal vision' defined as a final best-corrected visual acuity (BCVA) ≥ 20/25. Univariate, multivariate and decision-tree analyses were conducted to evaluate the clinical variables associated with 'normal vision'. Odds ratios (OR) and confidence intervals (CIs) were calculated.
Results: Of 327 eligible cases, 91 (27.8%) achieved 'normal vision' at 1 year. Multivariate analysis identified variables significantly associated with 'normal vision': shorter symptom duration (odds ratio [OR]=1.05; 95% confidence interval [CI]:1.02-1.09; p = 0.002), smaller preoperative OCT minimum linear diameter (OR per 100-micron increase = 1.65; 95%CI:1.31-2.08; p < 0.001) and better mean preoperative BCVA (OR = 15.13; 95%CI: 3.59-63.65; p < 0.001). The decision-tree analysis found that the most significant variable associated with 'normal vision' was symptom duration. 'Normal vision' was achieved in 70.6% of eyes operated within one week from symptom onset and in 45% of eyes with symptom duration between 1 and 3 weeks.
Conclusions: These findings suggested urgent surgery is justified for small macular holes of short duration.
(© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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