PDF(Pubmed)
Abstract：
Purpose: To report the results of a nonsurgical approach to repair macular holes (MHs). Methods: A retrospective chart review of consecutive patients with MHs from 2018 to 2021 was performed. Topical therapy consisted of a steroidal agent, a nonsteroidal agent, and a carbonic anhydrase inhibitor. Data collected included the size, stage, and duration of the MH; topical agents used and the duration; lens status; and complications. Macular edema was graded on a scale ranging from 0 (no edema) to 4 (large amount of edema) and recorded. Before and after MH closure, the best-corrected visual acuity (BCVA) was measured and converted to logMAR notation. Spectral-domain optical coherence tomography was performed. Results: Seven (54%) of the 13 eyes initially treated topically experienced successful MH closure. Small holes (<230 µm) with a better initial BCVA (0.474 logMAR vs 0.796 logMAR) were more likely to respond favorably to topical therapy (mean 121 µm vs 499 µm). In addition, holes with less surrounding edema responded better. All holes not responding to topical therapy were subsequently closed with pars plana vitrectomy, membrane peeling, and fluid-gas exchange. Conclusions: Topical therapy is a reasonable first-line treatment for MHs, with a better than 50% success rate. This is especially true for small early-onset holes with minimal or no edema. Surgery still had a high success rate after a 1- to 3-month delay while the MH was treated with eyedrops.
摘要：
目的：报告非手术方法修复黄斑裂孔（MHs）的结果。方法：对2018年至2021年的连续MHs患者进行回顾性分析。局部治疗包括类固醇药物，一种非甾体药物，和碳酸酐酶抑制剂.收集的数据包括大小，舞台,和MH的持续时间;使用的局部药物和持续时间;晶状体状态;和并发症。黄斑水肿以0(无水肿)至4(大量水肿)的范围分级并记录。在MH关闭之前和之后，测量最佳矫正视力（BCVA）并转换为logMAR表示法。进行了频域光学相干层析成像。结果:最初局部治疗的13只眼睛中有7只(54%)经历了成功的MH闭合。具有更好的初始BCVA（0.474logMARvs0.796logMAR）的小孔（<230µm）更有可能对局部治疗产生有利反应（平均121µmvs499µm）。此外,周围水肿较少的孔反应更好。所有对局部治疗无反应的孔随后用平坦部玻璃体切除术封闭。膜剥离,和流体-气体交换。结论:局部治疗是MHs合理的一线治疗,成功率超过50%。对于具有最小或没有水肿的小的早发性孔尤其如此。在用滴眼液治疗MH时，延迟1至3个月后，手术成功率仍然很高。
