Kusuhara Sentaro, Teraoka Escaño Michael F, Fujii Shigeki, Nakanishi Yoriko, Tamura Yasushi, Nagai Azusa, Yamamoto Hiroyuki, Tsukahara Yasutomo, Negi Akira
Department of Organ Therapeutics, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
Am J Ophthalmol. 2004 Nov;138(5):709-16. doi: 10.1016/j.ajo.2004.04.063.
To evaluate whether an index based on hole configuration can be used to predict visual outcome in eyes with idiopathic macular holes.
Prospective interventional case series.
Thirty-five eyes of 32 patients with idiopathic stage 2 or 3 macular hole were enrolled in this study. The best-corrected visual acuity (BCVA), cross-sectional image of the macular hole by optical coherence tomography (OCT), and retinal thickness in the central (<1000 microm), inner (1000 to 2220 microm), and outer ring areas (2220 to 3450 microm) as defined by the OCT retinal mapping program were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively. The change in retinal thickness of the inner ring area at the 6-month postoperative period was used to evaluate the degree of preoperative retinal deformation. The macular hole index (MHI) (ratio of hole height to base diameter of hole) was calculated and correlated with minimum diameter of hole, base diameter of hole, the postoperative decrease in macular thickness, and the postoperative BCVA. The postoperative BCVA was further evaluated in two patient-matched groups.
Retinal thickness values in the inner ring area were decreased at the 1-month postoperative period. MHI significantly correlated with the postoperative decrease in macular thickness in the inner ring area at 6 months (correlation coefficient = -0.632, P = .030, Spearman analysis) and with the postoperative BCVA (P = .013, multiple regression analysis). Postoperative BCVA in the MHI >/=0.5 group was better than that in the MHI <0.5 group (P = .032, Mann-Whitney test).
The MHI is a ratio easily calculated from OCT transverse images of the macular area. The MHI represents the preoperative configuration of a macular hole and is a prognostic factor for visual outcome.
评估基于裂孔形态的指标能否用于预测特发性黄斑裂孔患者的视力预后。
前瞻性干预性病例系列研究。
本研究纳入了32例患有特发性2期或3期黄斑裂孔患者的35只眼。术前及术后1、3、6和12个月评估最佳矫正视力（BCVA）、光学相干断层扫描（OCT）获得的黄斑裂孔横断面图像，以及OCT视网膜地图程序定义的中央（<1000微米）、内环（1000至2220微米）和外环区域（2220至3450微米）的视网膜厚度。术后6个月内环区域视网膜厚度的变化用于评估术前视网膜变形程度。计算黄斑裂孔指数（MHI）（裂孔高度与裂孔基底直径之比），并将其与裂孔最小直径、裂孔基底直径、术后黄斑厚度降低值及术后BCVA进行相关性分析。在两个匹配患者组中进一步评估术后BCVA。
术后1个月内环区域视网膜厚度值下降。MHI与术后6个月内环区域黄斑厚度降低值显著相关（相关系数=-0.632，P=0.030，Spearman分析），与术后BCVA也显著相关（P=0.013，多元回归分析）。MHI≥0.5组的术后BCVA优于MHI<0.5组（P=0.032，Mann-Whitney检验）。
MHI是一个可根据黄斑区OCT横向图像轻松计算得出的比值。MHI代表黄斑裂孔的术前形态，是视力预后的一个预测因素。
