Allen Ariana, Zheng Yuxi, Lee Terry, Joseph Suzanna, Zhang Xinxin, Feng Henry L, Fekrat Sharon
Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
Cape Fear Eye Associates, Fayetteville, NC, USA.
J Vitreoretin Dis. 2024 Jul 27;8(5):524-532. doi: 10.1177/24741264241264937. eCollection 2024 Sep-Oct.
To evaluate the clinical and optical coherence tomography (OCT) characteristics associated with progression of vitreomacular traction (VMT) to a full-thickness macular hole (FTMH) and lamellar macular hole (LMH). A retrospective cohort study of patients with an OCT-confirmed diagnosis of idiopathic VMT and 6 or more months of follow-up was performed. Clinical data included age, sex, race, systemic comorbidities, hormone replacement therapy, corrected visual acuity (VA), subjective visual symptoms, OCT signs, and the presence of or progression to FTMH or LMH. Of the 287 eyes with VMT, 48 (16.7%) progressed to MH. Twelve eyes (4.2%) progressed to LMH, and 36 eyes (12.5%) progressed to FTMH. Female sex ( = .02), myopic refractive status in phakic eyes ( = .02), subjective decreased VA ( = .01), and the presence of an inner segment-outer segment junction disruption on OCT ( = .003) were risk factors for progression from VMT to FTMH. Subjective metamorphopsia was a risk factor for progression to FTMH ( = .001) and LMH ( = .01). In a subgroup analysis, patients who had an FTMH in the fellow eye were significantly more likely to have VMT progress to FTMH in the study eye (24.0% vs 8.7%; = .04). Having an LMH in the fellow eye was not a risk factor for progression to LMH in the study eye ( = .47). Risk factors were found for the progression of VMT to MH that may be clinically relevant for risk-stratifying patients presenting with VMT.
评估与玻璃体黄斑牵引（VMT）进展为全层黄斑裂孔（FTMH）和板层黄斑裂孔（LMH）相关的临床及光学相干断层扫描（OCT）特征。对经OCT确诊为特发性VMT且随访6个月及以上的患者进行了一项回顾性队列研究。临床数据包括年龄、性别、种族、全身合并症、激素替代疗法、矫正视力（VA）、主观视觉症状、OCT体征，以及FTMH或LMH的存在情况或进展情况。在287只患有VMT的眼中，48只（16.7%）进展为黄斑裂孔。12只眼（4.2%）进展为LMH，36只眼（12.5%）进展为FTMH。女性（P = 0.02）、有晶状体眼的近视屈光状态（P = 0.02）、主观视力下降（P = 0.01）以及OCT上存在内节-外节连接中断（P = 0.003）是VMT进展为FTMH的危险因素。主观视物变形是进展为FTMH（P = 0.001）和LMH（P = 0.01）的危险因素。在亚组分析中，对侧眼有FTMH的患者，研究眼VMT进展为FTMH的可能性显著更高（24.0%对8.7%；P = 0.04）。对侧眼有LMH不是研究眼进展为LMH的危险因素（P = 0.47）。发现了VMT进展为黄斑裂孔的危险因素，这可能对VMT患者进行风险分层具有临床意义。
