Wu Mengai, Chen Lifeng, Fan Yuanyuan, Lin Li, Wang Zhijie, Yu Guanshun, Wu Xinyue, Lu Fan, Zheng Bin
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Front Med (Lausanne). 2025 Sep 10;12:1622151. doi: 10.3389/fmed.2025.1622151. eCollection 2025.
To evaluate the optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters as a prognostic indicator of visual outcome in patients with myopic foveoschisis (MF) and foveal detachment (FD).
Twenty-three individuals with MF and FD and undergoing vitrectomy participated in this study. Preoperative OCT parameters were obtained, including central foveal thickness (CFT), foveal detachment thickness (FDT), foveoschisis thickness (FST), and subfoveal choroidal thickness (SCT). Preoperative optical coherence tomography angiography (OCTA) images were assessed to measure macular vascular parameters in both superficial capillary plexus (SCP) and deep capillary plexus (DCP). En-face OCTA images was also employed to determine the area and perimeter of the ellipsoid zone (EZ) fracture. Microperimetry was performed to evaluate macular sensitivity (MS) covering the central 20°, 10°, 2° field centered at fovea.
The best corrected visual acuity (BCVA) improved significantly six months after surgery. When comparing groups based on postoperative BCVA, those with BCVA ≥0.5 had a substantially lower FD height and a higher vessel density (VD) in the SCP than those with BCVA <0.5. Preoperative BCVA demonstrated significant correlations with CFT, the EZ disruption area, and the EZ disruption perimeter. Additionally, preoperative 20° MS, 10° MS, and 2° MS were separately correlated with SCT, whole DCP VD, parafoveal VD, as well as the EZ disruption area and perimeter. Multiple linear regression analysis revealed that postoperative BCVA at six months was significantly associated with preoperative BCVA and preoperative whole SCP VD.
Our study highlights that in addition to preoperative visual acuity, OCTA may be a useful additional prognostic factor for predicting visual outcomes in patients with MF and FD after vitrectomy.
评估光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）参数，作为近视性黄斑劈裂（MF）和黄斑脱离（FD）患者视力预后的指标。
23例患有MF和FD且接受玻璃体切除术的患者参与了本研究。获取术前OCT参数，包括中心凹厚度（CFT）、黄斑脱离厚度（FDT）、黄斑劈裂厚度（FST）和黄斑下脉络膜厚度（SCT）。对术前光学相干断层扫描血管造影（OCTA）图像进行评估，以测量浅表毛细血管丛（SCP）和深部毛细血管丛（DCP）中的黄斑血管参数。还使用了OCTA的正面图像来确定椭圆体带（EZ）断裂的面积和周长。进行微视野检查以评估覆盖以黄斑为中心的中央20°、10°、2°视野的黄斑敏感度（MS）。
术后6个月最佳矫正视力（BCVA）显著改善。根据术后BCVA比较各组时，BCVA≥0.5的患者的FD高度明显低于BCVA<0.5的患者，且SCP中的血管密度（VD）更高。术前BCVA与CFT、EZ破坏面积和EZ破坏周长显著相关。此外，术前20°MS、10°MS和2°MS分别与SCT、整个DCP VD、黄斑旁VD以及EZ破坏面积和周长相关。多元线性回归分析显示，术后6个月的BCVA与术前BCVA和术前整个SCP VD显著相关。
我们的研究强调，除了术前视力外，OCTA可能是预测玻璃体切除术后MF和FD患者视力预后的一个有用的额外预后因素。
