Ohta Kouichi, Sato Atsuko, Senda Nami, Fukui Emi
Department of Ophthalmology, Matsumoto Dental University, Nagano, Japan.
Clin Ophthalmol. 2020 Jun 26;14:1777-1783. doi: 10.2147/OPTH.S257462. eCollection 2020.
We have shown distinct morphological changes of the foveal retina such as horizontally asymmetrical retinal thicknesses and displacements of the fovea toward the optic disc after successful idiopathic macular hole (MH) closure by MH surgery with internal limiting membrane (ILM) peeling. The purpose of this study was to determine whether these morphological changes will alter the stereoacuity.
This was a non-randomized, retrospective study conducted on patients who underwent MH surgery at the Matsumoto Dental University Hospital, Nagano, Japan.
Forty patients (22 women, 18 men) who underwent MH surgery with ILM peeling for a unilateral MH were studied. At >6 months after the PPV, the stereoacuity was measured with the Titmus stereotest (TST) and the TNO stereotest (TNO). The relationship between the stereoacuity and the age, MH size, best-corrected visual acuity (BCVA), foveal retinal thickness, and amount of nasal shift of the retina was determined.
The mean postoperative BCVA was -0.05 ± 0.11 logarithm of the minimum angle of resolution (logMAR) units. The percentage of cases with good stereoacuity of ≤100 sec of arc was 87.5% with the TST and ≤240" was 90% with the TNO test. A better stereoacuity was significantly correlated with a younger age ( = 0.36, <0.05; with TNO), smaller MH ( = 0.51, < 0.001, with TST), better postoperative BCVA ( = 0.43 <0.01 with TST; = 0.49, <0.01 with TNO), but not with the parafoveal retinal thickness or degree of nasal shift.
The postoperative stereopsis is relatively good in patients with better postoperative BCVA after MH surgery with ILM peeling, even though foveal morphological changes had occurred.
我们已经证实在通过内界膜（ILM）剥除的特发性黄斑裂孔（MH）手术成功封闭MH后，黄斑视网膜会出现明显的形态学变化，如视网膜厚度水平不对称以及黄斑向视盘移位。本研究的目的是确定这些形态学变化是否会改变立体视锐度。
这是一项对在日本长野松本齿科大学医院接受MH手术的患者进行的非随机回顾性研究。
对40例（22例女性，18例男性）因单侧MH接受ILM剥除的MH手术患者进行研究。在玻璃体切割术后>6个月，用Titmus立体视测试（TST）和TNO立体视测试（TNO）测量立体视锐度。确定立体视锐度与年龄、MH大小、最佳矫正视力（BCVA）、黄斑视网膜厚度以及视网膜鼻侧移位量之间的关系。
术后平均BCVA为-0.05±0.11最小分辨角对数（logMAR）单位。TST测试中立体视锐度≤100弧秒的良好病例百分比为87.5%，TNO测试中≤240"的为90%。更好的立体视锐度与年龄较小（TNO测试时r = 0.36，P<0.05）、MH较小（TST测试时r = 0.51，P<0.001）、术后BCVA较好（TST测试时r = 0.43，P<0.01；TNO测试时r = 0.49，P<0.01）显著相关，但与黄斑旁视网膜厚度或鼻侧移位程度无关。
在接受ILM剥除的MH手术后，尽管发生了黄斑形态学变化，但术后BCVA较好的患者术后立体视相对良好。
