Itoh Yuji, Inoue Makoto, Rii Tosho, Ando Yoshimasa, Hirakata Akito
Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2014 May 6;55(5):3003-11. doi: 10.1167/iovs.14-13973.
To determine whether the photoreceptor outer segments recover symmetrically after successful macular hole surgery, and whether the recovery is correlated with the degree of foveal displacement.
This was a retrospective, interventional case series. The medical records of 35 patients (n = 35 eyes) with a surgically closed macular hole were reviewed. Spectral-domain optical coherence tomography (SD-OCT) was used to obtain cross-sectional images across the fovea horizontally and vertically. The lengths of cone outer segment tips (COST) line defect in the temporal, nasal, superior, and inferior sectors of the fovea, the best-corrected visual acuity (BCVA), and the papillofoveal distance were measured before and at 6 and 12 months after the surgery.
The temporal COST line defect was significantly longer than the nasal length defect preoperatively (P = 0.031), at 6 months (P < 0.001), and at 12 months (P = 0.038) postoperatively. The length of the temporal COST line defect was significantly correlated with the BCVA preoperatively (P = 0.014) and at 6 months postoperatively (P = 0.001). The papillofoveal distance was significantly shorter at 6 months (P = 0.029) and 12 months (P = 0.043) postoperatively than at the baseline. The center of the COST line defect was located further temporally from the fovea postoperatively, and the distance was shorter than the nasal foveal displacement at 6 months (158.8 ± 167.0 μm, P = 0.13) and 12 months (244.8 ± 172.7 μm, P = 0.008).
The restoration of the temporal COST line was delayed after successful macular hole surgery. In addition, the fovea was displaced more nasally than the center of the COST line defect which recovered centripetally. (ClinicalTrials.gov number, NCT01959776.).
确定成功进行黄斑裂孔手术后光感受器外段是否对称恢复，以及恢复情况是否与黄斑中心凹移位程度相关。
这是一项回顾性干预性病例系列研究。回顾了35例（n = 35只眼）手术封闭黄斑裂孔患者的病历。使用光谱域光学相干断层扫描（SD - OCT）在水平和垂直方向获取穿过黄斑中心凹的横断面图像。测量手术前、术后6个月和12个月时黄斑中心凹颞侧、鼻侧、上方和下方扇形区域的视锥细胞外段尖端（COST）线缺损长度、最佳矫正视力（BCVA）以及视乳头黄斑距离。
术前（P = 0.031）、术后6个月（P < 0.001）和术后12个月（P = 0.038），颞侧COST线缺损明显长于鼻侧长度缺损。术前（P = 0.014）和术后6个月（P = 0.001），颞侧COST线缺损长度与BCVA显著相关。术后6个月（P = 0.029）和12个月（P = 0.043）时视乳头黄斑距离明显短于基线。术后COST线缺损中心在颞侧距黄斑中心凹更远，且该距离在6个月时（158.8 ± 167.0μm，P = 0.13）和12个月时（244.8 ± 172.7μm，P = 0.008）短于鼻侧黄斑移位。
成功进行黄斑裂孔手术后，颞侧COST线的恢复延迟。此外，黄斑中心凹向鼻侧移位比向心性恢复的COST线缺损中心更明显。（ClinicalTrials.gov编号，NCT01959776。）
