Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea.
Br J Ophthalmol. 2019 Feb;103(2):251-256. doi: 10.1136/bjophthalmol-2017-311810. Epub 2018 Apr 26.
To elucidate the clinical characteristics of a full-thickness macular hole (FTMH) with atypical epiretinal tissue (AET), and expand the spectrum of pathogenesis of MH.
This study involved 225 consecutive eyes of 211 patients who underwent surgery for an idiopathic FTMH. Eyes were divided into two groups according to the presence of AET. Tomographic features at baseline, closure rate of the MH and visual outcomes were compared between the two groups.
AET was detected in 26 (11.6%) among 225 eyes. Overall closure of the MH was noted in 92.3% of eyes with AET and 99.5% of eyes without AET at 12 months postoperatively (p=0.003). At 12 months postoperatively, the mean logarithm of the minimum angle of resolution visual acuity in eyes with and without AET was 0.38 and 0.21, respectively (p=0.046). At baseline, eyes with AET more frequently had splitting of the inner retina but fewer intact photoreceptors compared with eyes without AET (19.2% vs 2.5%, and 57.7% vs 89.9%, p<0.001, respectively).
The presence of AET in an FTMH was related to poorer anatomical success and less visual recovery after surgery, suggesting that AET reflects a chronic pathogenic process involving more severe damage to the foveal tissue.
阐明伴有非典型视网膜内界膜（AET）的全层黄斑裂孔（FTMH）的临床特征，并扩展 MH 的发病机制谱。
本研究涉及 211 名患者的 225 只连续眼，这些患者因特发性 FTMH 接受了手术。根据是否存在 AET，将这些眼分为两组。比较两组之间基线时的断层特征、MH 闭合率和视力结果。
在 225 只眼中，有 26 只（11.6%）检测到 AET。在术后 12 个月时，有 AET 的眼 MH 总体闭合率为 92.3%，无 AET 的眼为 99.5%（p=0.003）。术后 12 个月时，有 AET 和无 AET 的眼的最小角分辨率视觉敏度的平均对数分别为 0.38 和 0.21（p=0.046）。在基线时，与无 AET 的眼相比，有 AET 的眼更常出现内视网膜分裂，但完整的光感受器更少（19.2%与 2.5%，57.7%与 89.9%，分别为 p<0.001）。
在 FTMH 中存在 AET 与手术后解剖学成功较差和视力恢复较少有关，表明 AET 反映了涉及更严重的黄斑组织损伤的慢性发病过程。
