Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2024 Sep 6;19(9):e0308292. doi: 10.1371/journal.pone.0308292. eCollection 2024.
To investigate choroidal features of idiopathic macular hole (IMH) and determine their relationship with surgical outcomes.
Patients above stage II unilateral IMH who received pars plana vitrectomy (PPV) with the internal limiting membrane (ILM) peeling were enrolled for the retrospective observational study. Preoperative choriocapillaris perfusion (CCP), central choroidal thickness (CCT), base/minimum diameters (BD/MD) and height (HH) of MH were analyzed by optical coherence tomography angiography (OCTA). At 1, 3 and 6 months after PPV, CCT, central foveal thickness (CFT) and maximum parafoveal thickness (MPT) of closed MH were measured. Best-corrected visual acuity (BCVA) was assessed at every visit. The correlations between preoperative characteristics and surgical outcomes were assessed.
Twenty-seven patients were evaluated. All eyes (100%) showed successful MH closure after the primary surgery. Until postoperative 6 months, BCVA continued to improve significantly (p < 0.001), while CFT and CCT progressively thinned (p < 0.001, p < 0.001). On correlation tests, final postoperative BCVA was associated with preoperative BCVA (R = 0.506, p = 0.007) and CCP (R = -0.475, p = 0.012), while final CFT was related with preoperative CCT (R = 0.392, p = 0.043). Multiple regression analysis revealed that preoperative CCP was significantly related with final postoperative BCVA (β = -0.403, p = 0.049).
Preoperative CCP and CCT were respectively associated with functional and anatomical prognosis of IMH after PPV.
探讨特发性黄斑裂孔（IMH）的脉络膜特征及其与手术结果的关系。
回顾性观察研究纳入了接受经睫状体平坦部玻璃体切除术（PPV）联合内界膜（ILM）剥除术治疗的单侧 II 期以上 IMH 患者。通过光学相干断层扫描血管造影（OCTA）分析术前脉络膜毛细血管灌注（CCP）、中心脉络膜厚度（CCT）、黄斑裂孔基底/最小直径（BD/MD）和高度（HH）。在 PPV 后 1、3 和 6 个月测量闭合性 MH 的中央视网膜厚度（CFT）和最大旁中心视网膜厚度（MPT）。每次就诊时评估最佳矫正视力（BCVA）。评估术前特征与手术结果的相关性。
共评估了 27 例患者。所有眼（100%）在初次手术后均成功闭合 MH。直到术后 6 个月，BCVA 持续显著提高（p<0.001），而 CFT 和 CCT 逐渐变薄（p<0.001，p<0.001）。相关性检验显示，最终术后 BCVA 与术前 BCVA（R=0.506，p=0.007）和 CCP（R=-0.475，p=0.012）相关，而最终 CFT 与术前 CCT 相关（R=0.392，p=0.043）。多元回归分析显示，术前 CCP 与最终术后 BCVA 显著相关（β=-0.403，p=0.049）。
术前 CCP 和 CCT 分别与 PPV 后 IMH 的功能和解剖预后相关。
