Ozal Ece, Ermis Serhat, Gul Cengiz, Aksoy Burakhan Kursat, Karapapak Murat, Ozal Sadık Altan
Department of Ophthalmology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
BMC Ophthalmol. 2025 Jul 2;25(1):390. doi: 10.1186/s12886-025-04218-1.
To evaluate the prognostic significance of preoperative optical coherence tomography (OCT) parameters in predicting anatomical closure patterns following idiopathic macular hole (MH) surgery.
In this retrospective study, 61 eyes of 61 patients who underwent successful MH surgery were analyzed. Preoperatively, OCT-derived linear measurements and calculated indices, including the macular hole index (MHI), tractional hole index (THI), diameter hole index (DHI), hole form factor (HFF), and macular hole closure index (MHCI), as well as newly developed area-based indices such as the macular hole area index (MAI), macular hole tissue area index (MTAI), and macular hole cystoid space area index (MCSAI), were recorded. Anatomical closure was categorized into three types at the postoperative 6-month follow-up based on the integrity of the external limiting membrane (ELM) and ellipsoid zone (EZ): Type 1 (T1) (intact ELM and EZ), Type 2 (T2) (intact ELM and disrupted EZ), and Type 3 (T3) (disrupted ELM and EZ).
Among closure types, statistically significant differences were observed in OCT parameters, particularly in MHI, THI, DHI, and HFF. T1 closures exhibited significantly higher MHI and HFF compared to T3 ( < 0.05). THI was significantly higher in T1 compared to T2 and T3 ( < 0.05). However, no significant correlations were found between visual acuity gain or postoperative BCVA at 6 months and any of the OCT indices evaluated.
Preoperative OCT parameters, specifically MHI, HFF, and THI, effectively predicted anatomical closure patterns following MH surgery. However, their prognostic value for visual acuity improvement was limited. The anatomical closure alone does not ensure favorable visual outcomes; therefore, evaluating the restoration of outer retinal layers (ELM and EZ) is crucial.
评估术前光学相干断层扫描（OCT）参数在预测特发性黄斑裂孔（MH）手术后解剖学闭合模式方面的预后意义。
在这项回顾性研究中，分析了61例成功接受MH手术患者的61只眼。术前，记录了OCT得出的线性测量值和计算指标，包括黄斑裂孔指数（MHI）、牵拉性裂孔指数（THI）、裂孔直径指数（DHI）、裂孔形态因子（HFF）和黄斑裂孔闭合指数（MHCI），以及新开发的基于面积的指标，如黄斑裂孔面积指数（MAI）、黄斑裂孔组织面积指数（MTAI）和黄斑裂孔囊样间隙面积指数（MCSAI）。在术后6个月随访时，根据外限制膜（ELM）和椭圆体带（EZ）的完整性，将解剖学闭合分为三种类型：1型（T1）（ELM和EZ完整）、2型（T2）（ELM完整但EZ中断）和3型（T3）（ELM和EZ中断）。
在闭合类型之间，观察到OCT参数存在统计学显著差异，特别是在MHI、THI、DHI和HFF方面。与T3相比，T1闭合的MHI和HFF显著更高（<0.05）。与T2和T3相比，T1的THI显著更高（<0.05）。然而，在6个月时视力提高或术后最佳矫正视力（BCVA）与所评估的任何OCT指标之间未发现显著相关性。
术前OCT参数，特别是MHI、HFF和THI，能有效预测MH手术后的解剖学闭合模式。然而，它们对视力改善的预后价值有限。仅解剖学闭合并不能确保良好的视觉结果；因此，评估外层视网膜层（ELM和EZ）的恢复情况至关重要。
