Ruiz-Moreno J M, Staicu C, Piñero D P, Montero J, Lugo F, Amat P
Albacete Medical School, University of Castilla La Mancha, Albacete, Spain.
Br J Ophthalmol. 2008 May;92(5):640-4. doi: 10.1136/bjo.2007.136176.
To evaluate the use of preoperative optical coherence tomography (OCT) findings as predictive factors for macular hole (MH) surgery outcomes.
46 eyes from 46 patients with a diagnosis of MH were included in this study. In all cases, a pars plana 25-gauge vitrectomy with peeling of the internal limiting membrane was performed. Before and after surgery, a complete clinical examination and a detailed macular analysis, which included the MH minimum and base diameter, the MH height, the Macular Hole Index (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI), were performed. Predictive factors for visual prognosis after surgery were obtained by receiver operating characteristic curve analysis.
Minimum and base diameter as well as THI and MHI correlated significantly (p<0.01, p = 0.01, p = 0.04, p = 0.03, respectively) with postoperative best spectacle corrected visual acuity at 3 months, but DHI and MH height did not. Cut-off values of 311 microm and 1.41 were obtained for the minimum diameter and THI, respectively, from receiver operating characteristic curve analysis, providing an acceptable sensitivity and specificity.
An MH minimum diameter of <311 microm or a THI >1.41 are predictive factors for a good visual prognosis after MH surgery.
评估术前光学相干断层扫描（OCT）结果作为黄斑裂孔（MH）手术预后预测因素的应用价值。
本研究纳入46例诊断为MH的患者的46只眼。所有病例均行25G玻璃体切除术联合内界膜剥除术。手术前后均进行全面的临床检查及详细的黄斑分析，包括MH最小直径、基底直径、MH高度、黄斑裂孔指数（MHI）、直径裂孔指数（DHI）及牵拉性裂孔指数（THI）。通过受试者工作特征曲线分析获得手术后视功能预后的预测因素。
最小直径、基底直径以及THI和MHI与术后3个月最佳矫正视力显著相关（分别为p<0.01、p = 0.01、p = 0.04、p = 0.03），但DHI和MH高度与之无关。通过受试者工作特征曲线分析，最小直径和THI的截断值分别为311微米和1.41，具有可接受的敏感性和特异性。
MH最小直径<311微米或THI>1.41是MH手术后良好视功能预后的预测因素。
