Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ophthalmology. 2012 Oct;119(10):2133-40. doi: 10.1016/j.ophtha.2012.05.018. Epub 2012 Aug 4.
To evaluate the elongation profile of foveal tissue after macular hole (MH) surgery and to investigate its impact on visual function.
Prospective, interventional case series.
Thirty-one eyes from 31 patients who underwent surgery for an MH less than 400 μm in diameter.
The distance between the parafoveal edge of the outer plexiform layer (OPL) was defined as the inter-OPL distance and measured on the basis of optical coherence tomography images at the first postoperative visit and the 2- and 6-month postoperative visits. Further elongation of the foveal tissue in certain directions was defined as asymmetric elongation. The association of the mean degree of asymmetric elongation with visual acuity and metamorphopsia score (M-score) outcome was evaluated.
Inter-OPL distance and M-score.
Macular hole sealing was noted in all eyes after surgery. The horizontal inter-OPL distances measured at the defined time points were 361.6±99.6 μm, 558.8±93.3 μm, and 575.4±94.8 μm, respectively. The vertical inter-OPL distances were 324.2±93.8 μm, 481.2±104.6 μm, and 494.6±85.0 μm, respectively. Both the horizontal and vertical inter-OPL distances were increased during the follow-up period (P<0.001). Horizontal inter-OPL distances were significantly longer than vertical distances at 1, 2, and 6 months (P<0.001, P<0.001, and P<0.001, respectively). Further nasal and superior elongation was noted on the horizontal and vertical planes in 90.3% and 61.3% of eyes, respectively. The mean degree of asymmetric spreading was significantly associated with an M-score at 6 months postoperatively (P = 0.044) and a difference in M-score between preoperative and 6-month postoperative examinations (P = 0.027).
Elongation of the foveal tissue was noted after MH surgery. This elongation was usually asymmetric, and the degree of asymmetry was associated with postoperative metamorphopsia.
评估黄斑裂孔（MH）手术后中心凹组织的伸长情况，并探讨其对视力功能的影响。
前瞻性、干预性病例系列研究。
31 只眼，共 31 例患者，接受了直径小于 400μm 的 MH 手术。
将外丛状层（OPL）的旁中心凹边缘之间的距离定义为内 OPL 距离，并在术后第 1 次和第 2、6 个月的光学相干断层扫描图像上进行测量。将特定方向的中心凹组织进一步伸长定义为不对称伸长。评估平均不对称伸长程度与视力和变形分数（M-评分）结果之间的关系。
内 OPL 距离和 M-评分。
所有眼在手术后均观察到黄斑裂孔封闭。在规定的时间点测量的水平内 OPL 距离分别为 361.6±99.6μm、558.8±93.3μm 和 575.4±94.8μm。垂直内 OPL 距离分别为 324.2±93.8μm、481.2±104.6μm 和 494.6±85.0μm。在随访期间，水平和垂直内 OPL 距离均增加（P<0.001）。水平内 OPL 距离在 1、2 和 6 个月时明显长于垂直距离（P<0.001、P<0.001 和 P<0.001）。在 90.3%和 61.3%的眼的水平和垂直平面上分别观察到鼻侧和上侧进一步伸长。术后 6 个月的平均不对称扩展程度与 M-评分显著相关（P=0.044），与术前和术后 6 个月 M-评分的差异显著相关（P=0.027）。
MH 手术后观察到中心凹组织伸长。这种伸长通常是不对称的，不对称的程度与术后变形有关。
