Ang Angelique Chiu, Hsieh Yi-Ting, Tsui Mei-Chi, Lai Tso-Ting, Yang Chung-May
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ophthalmologica. 2022;245(2):187-193. doi: 10.1159/000521731. Epub 2022 Jan 5.
This study aimed to investigate the clinical features and treatment outcomes of idiopathic full-thickness macular hole (FTMH) without vitreomacular separation (VMS).
Consecutive cases of idiopathic FTMH at one tertiary center from January 2013 to April 2020 were retrospectively recruited. They were separated into two groups according to the findings in optical coherence tomography (OCT): FTMH with VMS and FTMH without VMS. Ophthalmic examinations and OCT were performed pre- and postoperatively. The clinical findings were compared between the two groups.
Of the total 124 cases, 15 (12.1%) were noted as FTMH without VMS with the presence of an attached posterior hyaloid (PH) at macula. The macular hole (MH) size was smaller (276.06 ± 170.10 μm) compared to those with VMS (492.83 ± 209.31 μm) (p < 0.001). The incidence of lamellar hole-associated epiretinal proliferation (LHEP) was much higher in this group (13/15, 86.7%) compared to FTMH with VMS (11/109, 10.1%) (p < 0.001). A higher rate of spontaneous closure of MH (13.3%) was also noted in FMTH without VMS (13.3% vs. 0.9% in FTMH with VMS, p = 0.040). After operation, the MH closure rate was 93.3%. The postoperative best-corrected visual acuity was not significantly different between the two groups (p = 0.098).
A small percentage (12.1% in this series) of idiopathic FTMH had no VMS. The completely attached PH along with the high incidence of LHEP implied a tangential traction in FTMH without VMS. The MH size was usually small, and the postoperative outcomes were similar to those of conventional FTMH with VMS.
本研究旨在调查无玻璃体黄斑分离（VMS）的特发性全层黄斑裂孔（FTMH）的临床特征和治疗结果。
回顾性招募了2013年1月至2020年4月在一家三级中心连续收治的特发性FTMH病例。根据光学相干断层扫描（OCT）结果将其分为两组：伴有VMS的FTMH和不伴有VMS的FTMH。在术前和术后进行眼科检查和OCT。比较两组的临床结果。
在总共124例病例中，15例（12.1%）被判定为无VMS的FTMH，黄斑区存在附着的后玻璃体膜（PH）。与伴有VMS的病例（492.83±209.31μm）相比，黄斑裂孔（MH）大小较小（276.06±170.10μm）（p<0.001）。与伴有VMS的FTMH（109例中的11例，10.1%）相比，该组板层裂孔相关视网膜前增殖（LHEP）的发生率要高得多（15例中的13例，86.7%）（p<0.001）。在无VMS的FMTH中也观察到较高的MH自发闭合率（13.3%）（无VMS的FMTH为13.3%，伴有VMS的FTMH为0.9%，p=0.040）。术后，MH闭合率为93.3%。两组术后最佳矫正视力无显著差异（p=0.098）。
一小部分（本系列中为12.1%）特发性FTMH无VMS。完全附着的PH以及LHEP的高发生率提示无VMS的FTMH存在切线牵引。MH大小通常较小，术后结果与伴有VMS的传统FTMH相似。
