Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
Retina. 2024 Feb 1;44(2):237-245. doi: 10.1097/IAE.0000000000003943.
To investigate the characteristics of spontaneously closed full-thickness macular holes (FTMHs) and to seek potential predictors for the spontaneous closure of FTMHs.
In this retrospective cohort study, the clinical data and optical coherence tomography images were reviewed from 19 eyes with spontaneously closed FTMHs (spontaneous closure group) and 37 control eyes with FTMHs that were delayed for nonmedical reasons, but ultimately required surgery (control group). The term, suspended hyperreflective material, was defined as hyperreflective material suspended within the FTMHs observed via optical coherence tomography; the presence of suspended hyperreflective material was evaluated in these eyes.
The median time from diagnosis to spontaneous closure of the FTMHs was 13.7 (range, 2.4-32.4) weeks in the spontaneous closure group. The mean diameter of FTMHs in the spontaneous closure group was significantly smaller than that in the control group (191.68 ± 70.57 vs. 401.68 ± 162.19 µ m, P < 0.0001). The incidence of vitreomacular traction was higher in the spontaneous closure group compared with the control group (9/19 vs. 5/37, P = 0.009, odds ratio [95% confidence interval], 5.76 [1.56-21.21]); in seven of the nine eyes with vitreomacular traction from the spontaneous closure group, spontaneous vitreomacular traction separation and subsequent FTMH closure was observed. Suspended hyperreflective material was observed in nine eyes (47%) from the spontaneous closure group and three eyes (8%) from the control group ( P = 0.001, odds ratio [95% confidence interval], 10.20 [2.31‒45.02]).
Smaller diameters, vitreomacular traction, and presence of suspended hyperreflective material may be suggestive of the potential for spontaneous closure of FTMHs.
研究自发闭合的全层黄斑裂孔(FTMHs)的特征,并寻找FTMH 自发闭合的潜在预测因素。
在这项回顾性队列研究中,对 19 只自发闭合的全层黄斑裂孔(自发闭合组)和 37 只因非医疗原因而延迟但最终需要手术的全层黄斑裂孔(对照组)的临床数据和光学相干断层扫描图像进行了回顾。术语“悬浮高反射物质”被定义为通过光学相干断层扫描观察到的悬于 FTMHs 内的高反射物质;评估了这些眼中悬浮高反射物质的存在。
自发闭合组中,从诊断到 FTMH 自发闭合的中位时间为 13.7(范围 2.4-32.4)周。自发闭合组 FTMH 的平均直径明显小于对照组(191.68±70.57µm 比 401.68±162.19µm,P<0.0001)。与对照组相比,自发闭合组中玻璃体黄斑牵引的发生率更高(9/19 比 5/37,P=0.009,比值比[95%置信区间],5.76[1.56-21.21]);在自发闭合组的 9 只眼中,观察到玻璃体黄斑牵引自发分离,随后 FTMH 闭合。自发闭合组的 9 只眼(47%)和对照组的 3 只眼(8%)观察到悬浮高反射物质(P=0.001,比值比[95%置信区间],10.20[2.31-45.02])。
较小的直径、玻璃体黄斑牵引和悬浮高反射物质的存在可能提示 FTMH 有自发闭合的潜力。