Qi Biying, Yu Yanping, You Qisheng, Wang Zengyi, Wang Jing, Liu Lingzi, Liu Wu
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
Graefes Arch Clin Exp Ophthalmol. 2020 Oct;258(10):2117-2124. doi: 10.1007/s00417-020-04814-5. Epub 2020 Jun 30.
To explore the evolution of outer foveolar lucency (OFL) after vitrectomy and the correlation between OFL and visual acuity (VA) outcome in eyes with large idiopathic macular hole (IMH).
In this retrospective study, 244 eyes of 233 subjects with large IMH (diameter > 400 μm), who underwent vitrectomy, were included. Preoperative clinical data, postoperative optical coherence tomography (OCT) images, and VA at 1-, 4-, and 10-month visits were documented. The prevalence, incidence, and width of OFL and their correlation with postoperative VA were analyzed.
The prevalence of OFL was 10.4% (24/231) at 1 month and significantly increased to 30.4% (55/181) at 4 months (P < 0.001) and 34.2% (25/73) at 10 months (P < 0.001). The incidence was 26.1% (40/153) and 22.0% (9/41) at 4 and 10 months, respectively. OFL appeared at 1 month while disappeared at 4 or 10 months in 8 eyes (50.0%). The presence of OFL at 1 month was negatively associated with IMH diameter (Nagelkerke R = 0.06; P = 0.02). Eyes with OFL at 4 months had better VA at their 4-month visit than eyes without OFL (P = 0.02). Eyes with early-developed OFLs had better VA at 10 months than those with later-developed ones (P = 0.02). Width of OFL was not associated with postoperative VA at any point.
OFL is not rare in eyes with large IMH after surgery. It can occur gradually and remain during the 10-month follow-up. The presence of OFL appears to have no negative impact on the postoperative VA and it may represent the remodeling of foveal photoreceptors.
探讨玻璃体切除术后黄斑中心凹外透亮区（OFL）的演变情况，以及其与特发性大黄斑裂孔（IMH）患者视力（VA）预后的相关性。
本回顾性研究纳入了233例接受玻璃体切除术的特发性大黄斑裂孔（直径>400μm）患者的244只眼。记录术前临床资料、术后光学相干断层扫描（OCT）图像以及术后1、4和10个月时的视力。分析OFL的患病率、发生率、宽度及其与术后视力的相关性。
OFL的患病率在术后1个月时为10.4%（24/231），在4个月时显著增加至30.4%（55/181）（P<0.001），在10个月时为34.2%（25/73）（P<0.001）。其发生率在4个月和10个月时分别为26.1%（40/153）和22.0%（9/41）。8只眼（50.0%）的OFL在1个月时出现，在4个月或10个月时消失。1个月时OFL的存在与IMH直径呈负相关（Nagelkerke R=0.06；P=0.02）。4个月时存在OFL的眼在4个月随访时的视力优于无OFL的眼（P=0.02）。早期出现OFL的眼在10个月时的视力优于晚期出现OFL的眼（P=0.02）。OFL的宽度在任何时间点均与术后视力无关。
玻璃体切除术后特发性大黄斑裂孔眼中OFL并不少见。它可逐渐出现并在10个月的随访期间持续存在。OFL的存在似乎对术后视力无负面影响，可能代表了黄斑区光感受器的重塑。
