Kumar Sonu, Rao G Nageswar, Sinha Nidhi, Rath Bhumika, Pattanayak Sabya Sachi, Pal Arttatrana
Department of Zoology, School of Life Sciences, Mahatma Gandhi Central University, Motihari, Bihar, 845401, India.
Department of Ophthalmology, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, 751024, India.
Heliyon. 2024 Oct 11;10(20):e39261. doi: 10.1016/j.heliyon.2024.e39261. eCollection 2024 Oct 30.
Idiopathic macular hole (IMH) is a condition that arises from a combination of interactions among several forces on the fovea, remarkably from vitreous traction in the anteroposterior and tangential directions. Recent studies have highlighted the significance of microincision vitrectomy surgery, and IMH surgery was performed with minimal invasiveness, and visual improvement was an expected outcome. This study aimed to observe the pre-operative optical coherence tomography (OCT) indices correlated with visual acuity in the closure of IMH after surgery. Primarily, the findings were associated with clinical characteristics, including OCT indices, change in best corrected visual acuity (BCVA), clinical factors associated with IMH closure, and prognostic factors for the visual outcomes. This retrospective study included pre- and post-operative BCVA and OCT indices of 110 eyes with IMH. Each OCT variable was subjected to stepwise regression analysis regarding therapeutic factors that predict the need for IMH closure. Our results revealed that the hole form factor (HFF, r = 0.196), macular hole index (MHI, r = 0.669), and tractional hole index (THI, r = 0.085) had a positive correlation with visual acuity. However, basal hole diameter (BHD, r = -0.696) and minimum hole diameter (MHD, r = -0.407) showed a negative correlation. Out of them, HFF, MHI, BHD, and MHD were observed to be statistically significant (p < 0.05). The mean follow-up time was 149 ± 63.22 (85-300) days. The mean baseline BCVA was 0.75 ± 0.44 logMAR (Logarithm of the Minimum Angle of Resolution) units, which was improved to 0.29 ± 0.27 logMAR units at the final follow-up. The surgical success closure rate was 100 % among subjects with IMH. In conclusion, OCT indices were significant indicators of visual success rates in IMH, and OCT measurement could be employed as a single key index in predicting the IMH closure rate. Also, our findings suggested that OCT indices could be utilized as a safe and effective predictor of visual and anatomical outcomes in the case of IMH.
特发性黄斑裂孔（IMH）是一种由多种作用于黄斑中心凹的力相互作用而引发的疾病，尤其是前后方向和切线方向的玻璃体牵拉。近期研究突出了微创玻璃体切割手术的重要性，IMH手术以微创方式进行，视力改善是预期结果。本研究旨在观察IMH手术后裂孔闭合过程中与视力相关的术前光学相干断层扫描（OCT）指标。主要而言，研究结果与临床特征相关，包括OCT指标、最佳矫正视力（BCVA）的变化、与IMH闭合相关的临床因素以及视力预后因素。这项回顾性研究纳入了110只患有IMH的眼睛的术前和术后BCVA及OCT指标。针对预测IMH闭合需求的治疗因素，对每个OCT变量进行逐步回归分析。我们的结果显示，裂孔形态因子（HFF，r = 0.196）、黄斑裂孔指数（MHI，r = 0.669）和牵拉性裂孔指数（THI，r = 0.085）与视力呈正相关。然而，基底裂孔直径（BHD，r = -0.696）和最小裂孔直径（MHD，r = -0.407）呈负相关。其中，HFF、MHI、BHD和MHD具有统计学意义（p < 0.05）。平均随访时间为149 ± 63.22（85 - 300）天。平均基线BCVA为0.75 ± 0.44 LogMAR（最小分辨角对数）单位，在最终随访时提高到0.29 ± 0.27 LogMAR单位。IMH患者的手术成功闭合率为100%。总之，OCT指标是IMH视力成功率的重要指标，OCT测量可作为预测IMH闭合率的单一关键指标。此外，我们的研究结果表明，在IMH病例中，OCT指标可作为视力和解剖学结果的安全有效预测指标。
