Eye Clinic, Polytechnic University of Marche, via Conca 61, 60126, Ancona, Italy.
Graefes Arch Clin Exp Ophthalmol. 2020 Aug;258(8):1655-1662. doi: 10.1007/s00417-020-04719-3. Epub 2020 May 3.
To evaluate the correlations between anatomical and functional changes in idiopathic macular hole (IMH) surgery in long-term follow-up.
This is a prospective, interventional single centre case series. The final sample is formed by 14 eyes of 14 patients who had undergone IMH surgery in our institution between 2005 and 2009 and were still followed up in 2019. Reported data were pre- and post-operative best-corrected visual acuity (BCVA), retinal sensitivity and fixation stability values on MP-1 and structural macular features on spectral domain optical coherence tomography. Optical coherence tomography angiography (OCTA) was utilized to assess microvascular characteristics at the final visit. Only patients with a successful MH closure were enrolled, excluding eyes affected by other relevant pathologies.
Mean BCVA improvement was significant after surgery (t test, p value < 0.001) and presented a slight, not statistically significant raise, between the post-operative and long-term follow-up. Differently, mean retinal sensibility (dB) showed a highly statistically significant difference between pre-operative and post-operative (t test, p value = .002) and post-operative and last follow-up (p value < 0.001). In the long-term follow-up, subjects having integrity of the inner segment/outer segment (IS/OS) layer showed no statistically significant difference in BCVA compared with subjects with IS/OS discontinuity (t test, p value = 0.72). OCTA parameters of the operated eye showed no statistical significance compared with the fellow eye.
In successfully closed MHs, retinal sensibility measured by microperimetry significatively increases after a long follow-up period even when BCVA remains stable or raises slightly. Vessel density organization tends to be quantitatively similar to fellow eye several years after surgery.
评估特发性黄斑裂孔（IMH）手术长期随访中解剖和功能变化的相关性。
这是一项前瞻性、干预性单中心病例系列研究。最终样本由 2005 年至 2009 年在我院接受 IMH 手术且 2019 年仍在随访的 14 例 14 只眼的患者组成。报告的数据为术前和术后最佳矫正视力（BCVA）、MP-1 上视网膜敏感度和固视稳定性值以及频域光相干断层扫描的结构黄斑特征。在最后一次就诊时利用光学相干断层血管造影术（OCTA）评估微血管特征。仅纳入 MH 闭合成功的患者，排除受其他相关病变影响的眼。
手术后 BCVA 显著提高（t 检验，p 值<0.001），且在术后和长期随访之间略有升高，但无统计学意义。相比之下，平均视网膜敏感度（dB）在术前和术后（t 检验，p 值=0.002）以及术后和最后一次随访（p 值<0.001）之间存在高度统计学差异。在长期随访中，具有内节/外节（IS/OS）层完整性的患者与 IS/OS 不连续的患者相比，BCVA 无统计学差异（t 检验，p 值=0.72）。与对侧眼相比，手术眼的 OCTA 参数无统计学意义。
在 MH 闭合成功的情况下，即使 BCVA 保持稳定或略有提高，微视野测量的视网膜敏感度在长期随访后仍显著增加。手术后数年，血管密度组织趋于与对侧眼定量相似。
