Rao Prethy, Yonekawa Yoshihiro, Abbey Ashkan M, Shah Aparna A, Wolfe Jeremy D, Faia Lisa J
Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan.
Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Associated Retinal Consultants, Royal Oak, Michigan.
Ophthalmol Retina. 2017 Mar-Apr;1(2):158-164. doi: 10.1016/j.oret.2016.09.014. Epub 2016 Nov 30.
To report the prevalence and surgical outcomes of macular holes (MHs) in eyes with age-related macular degeneration (AMD).
Interventional, retrospective, consecutive case series.
Patients with MH and concurrent non-neovascular (NNV) or neovascular (NV) AMD.
The records of 27 912 patients diagnosed with AMD between 2009 and 2014 at Associated Retinal Consultants were reviewed. Demographic data, visual acuity (VA), funduscopic examination, and optical coherence tomography were reviewed in those with a concurrent diagnosis of MH.
The VA and MH closure status.
A total of 15 196 patients with NNV and 12 716 patients with NV AMD were identified. A total of 199 eyes (0.7%) had MHs (160 NNV [1.1%]; 39 NV [0.3%]). Mean time to diagnosis of MH after the initial visit was 11.2 months (7.1 NNV; 24.8 NV). A total of 127 eyes underwent surgical repair (106 NNV; 21 NV). The final closure rate in those who underwent vitrectomy was 89.8% (91.5% NNV; 81.0% NV) and 25.0% in those who were observed (18.5% NNV, P < 0.0001; 44.4% NV, P = 0.02). Preoperative logarithm of the minimum angle of resolution VAs in NNV and NV AMD was 0.8±0.4 and 0.8±0.5, respectively, and final VA was 0.6±0.5 (P < 0.001) and 0.9±0.6 (P = 0.52), respectively. Mean follow-up time was 5.0 years.
The prevalence of MH was higher in eyes with NNV AMD than in those with NV AMD. The surgical closure rate was comparable in both groups, but VA improvement reached statistical significance only in the NNV AMD group.
报告年龄相关性黄斑变性（AMD）患者黄斑裂孔（MH）的患病率及手术结果。
干预性、回顾性、连续性病例系列研究。
患有MH且合并非新生血管性（NNV）或新生血管性（NV）AMD的患者。
回顾了2009年至2014年间在联合视网膜顾问中心诊断为AMD的27912例患者的记录。对同时诊断为MH的患者的人口统计学数据、视力（VA）、眼底检查和光学相干断层扫描进行了回顾。
视力和MH闭合状态。
共识别出15196例NNV患者和12716例NV AMD患者。共有199只眼（0.7%）患有MH（160只NNV眼[1.1%]；39只NV眼[0.3%]）。初次就诊后至MH诊断的平均时间为11.2个月（NNV组7.1个月；NV组24.8个月）。共有127只眼接受了手术修复（106只NNV眼；21只NV眼）。接受玻璃体切除术的患者最终闭合率为89.8%（NNV组91.5%；NV组81.0%），观察等待的患者闭合率为25.0%（NNV组18.5%，P<0.0001；NV组44.4%，P=0.02）。NNV和NV AMD患者术前最小分辨角视力的对数分别为0.8±0.4和0.8±0.5，最终视力分别为0.6±0.5（P<0.001）和0.9±0.6（P=0.52）。平均随访时间为5.0年。
NNV AMD患者中MH的患病率高于NV AMD患者。两组的手术闭合率相当，但仅NNV AMD组的视力改善具有统计学意义。
