Lake Stewart, Williams Keryn, Bottema Murk, Reynolds Karen
Medical Device Research Institute, College of Science & Engineering, Flinders University, Adelaide, SA, Australia.
Health & Medical Research Institute, College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia.
J Vitreoretin Dis. 2025 Sep 10:24741264251367112. doi: 10.1177/24741264251367112.
To examine whether vitrectomy surgery for macular hole alters the 3-dimensional shape of the macula. Macular shape was measured on radially oriented spectral-domain optical coherence tomography scans centered on the fovea. Eyes of patients with a macular hole were imaged before and after surgical repair. Eyes of individuals who had experienced a spontaneous posterior vitreous detachment (PVD) were also imaged. Pre- and postoperative shape was compared using the mean and range of best-fit curvature, and the difference between the best-fit curvature and retinal shape. Fifty-two eyes of 17 men and 35 women with a macular hole (mean ± SD age 69.2 ± 8.0 years) were studied. The mean (±SD) axial length was 23.84 ± 1.63 mm. A successful surgical outcome was achieved in 48 of the 52 eyes. Mean (±SD) macular curvature was significantly reduced, from 0.027 ± 0.016 mm presurgery to 0.025 ± 0.015 mm postsurgery ( = .01). There were no other significant differences in macular shape measurements between the pre- and postoperative states (all > .05). No significant change in macular shape was observed in the 28 eyes scanned before and after spontaneous PVD. Surgery for macular hole produces a significant reduction in macular curvature, not seen in eyes that develop a spontaneous PVD. These findings support the hypothesis that a mechanical force acts broadly across the macula in macular hole and may have implications for the area of intervention required for surgical repair.
为了研究黄斑裂孔玻璃体切除术是否会改变黄斑的三维形状。黄斑形状通过以中央凹为中心的径向取向光谱域光学相干断层扫描进行测量。黄斑裂孔患者的眼睛在手术修复前后进行成像。经历过自发性玻璃体后脱离（PVD）的个体的眼睛也进行成像。使用最佳拟合曲率的平均值和范围以及最佳拟合曲率与视网膜形状之间的差异来比较术前和术后形状。对17名男性和35名女性的52只患有黄斑裂孔的眼睛（平均±标准差年龄69.2±8.0岁）进行了研究。平均（±标准差）眼轴长度为23.84±1.63mm。52只眼中有48只手术结果成功。黄斑平均曲率（±标准差）显著降低，从术前的0.027±0.016mm降至术后的0.025±0.015mm（P = 0.01）。术前和术后状态之间的黄斑形状测量没有其他显著差异（所有P>0.05）。在28只自发PVD前后扫描的眼睛中未观察到黄斑形状有显著变化。黄斑裂孔手术导致黄斑曲率显著降低，这在发生自发性PVD的眼睛中未见到。这些发现支持了这样的假设，即机械力在黄斑裂孔中广泛作用于黄斑，并且可能对手术修复所需的干预区域有影响。
