Darade Shubham, Kathare Rupal, Choudhary Ayushi, Sehgal Gaurang, Chhablani Jay, Godani Kanika, Yadav Naresh Kumar, Gandhi Priyanka, Hande Prathiba, Mangla Rubble, Prabhu Vishma, Venkatesh Ramesh
Dept. of Retina-Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R block Rajaji Nagar, Bengaluru, 560010, India.
Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA.
Int J Retina Vitreous. 2024 Oct 14;10(1):77. doi: 10.1186/s40942-024-00597-7.
This study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs).
A retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed.
Idiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups.
Secondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management.
本研究旨在比较特发性和继发性全层黄斑裂孔（MHs）患者的人口统计学特征、临床特征及术后结果。
对2017年6月至2023年12月期间接受治疗的339例患者的348只眼进行回顾性分析。该研究纳入了特发性和继发性MHs病例，排除未进行手术或随访不足的病例。分析了人口统计学数据、视力（VA）、眼部特征及光学相干断层扫描测量结果。
308只眼（89%）为特发性MHs，40只眼（11%）为继发性MHs。特发性MH患者年龄较大（平均年龄：68.26岁对60.13岁；p = 0.001），女性更为常见（63%对40%；p = 0.005）。所有MHs中86%实现了术后闭合，VA中位数改善15个ETDRS字母（3行Snellen视力表）。然而，与特发性MHs相比，继发性MHs的闭合率较低（67%对89%，p = 0.001），VA改善较少（2行对3行，p = 0.001）。两组之间在最大基底直径和裂孔直径指数方面存在显著差异。
继发性MHs占手术病例的11%，其解剖和视觉结果比特发性MHs差。尽管成功率较低，但建议对继发性MHs进行早期手术干预以改善结果。区分特发性和继发性MHs对于优化治疗至关重要。
