Obata Shumpei, Ichiyama Yusuke, Kakinoki Masashi, Sawada Osamu, Saishin Yoshitsugu, Ohji Masahito
Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan.
Clin Ophthalmol. 2019 Dec 19;13:2541-2546. doi: 10.2147/OPTH.S231363. eCollection 2019.
The classification of lamellar macular holes (LMHs) into two subtypes has recently been proposed. However, the effectiveness of vitrectomy for treatment of each type of LMH is not well established. The goal of this study was to compare functional and anatomic changes after vitrectomy between eyes with degenerative LMH and those with tractional LMH.
This was a retrospective analysis of the medical records of patients with LMH who underwent vitrectomy. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured preoperatively (baseline), as well as at 1, 3 and 12 months postoperatively. BCVA and CMT were compared between eyes with degenerative LMH and those with tractional LMH.
Thirty-two eyes met the inclusion criteria. Thirteen eyes were diagnosed with degenerative LMH and 19 eyes were diagnosed with tractional LMH. Compared with baseline BCVA, postoperative BCVA improved significantly at 12 months postoperatively: from 0.33 to 0.12 logarithm of the minimum angle of resolution (logMAR) in eyes with degenerative LMH and from 0.30 to 0.12 logMAR in eyes with tractional LMH (p < 0.05 for both comparisons). BCVA at 12 months postoperatively did not significantly differ between the two groups. CMT decreased significantly from 419.4 µm at baseline to 364.2 µm at 12 months postoperatively in eyes with tractional LMH (p < 0.05); conversely, there was no significant difference in eyes with degenerative LMH (315.5 µm baseline to 314.9 µm at 12 months postoperatively; p > 0.05).
Vitrectomy improved BCVA in eyes with degenerative LMH as well as in eyes with tractional LMH. BCVA at 12 months postoperatively did not differ between the two groups.
最近有人提出将板层黄斑裂孔(LMH)分为两种亚型。然而,玻璃体切除术治疗每种类型LMH的有效性尚未得到充分证实。本研究的目的是比较变性性LMH眼和牵引性LMH眼玻璃体切除术后的功能和解剖学变化。
这是一项对接受玻璃体切除术的LMH患者病历的回顾性分析。术前(基线)以及术后1、3和12个月测量最佳矫正视力(BCVA)和中心黄斑厚度(CMT)。比较变性性LMH眼和牵引性LMH眼的BCVA和CMT。
32只眼符合纳入标准。13只眼被诊断为变性性LMH,19只眼被诊断为牵引性LMH。与基线BCVA相比,术后12个月时BCVA显著改善:变性性LMH眼从0.33对数最小分辨角(logMAR)提高到0.12,牵引性LMH眼从0.30 logMAR提高到0.12(两组比较均p<0.05)。术后12个月时两组之间的BCVA无显著差异。牵引性LMH眼的CMT从基线时的419.4 µm显著降至术后12个月时的364.2 µm(p<0.05);相反,变性性LMH眼无显著差异(基线时315.5 µm至术后12个月时314.9 µm;p>0.05)。
玻璃体切除术改善了变性性LMH眼和牵引性LMH眼的BCVA。术后12个月时两组之间的BCVA无差异。