Abstract：
OBJECTIVE: To investigate the predictive factors for postsurgical visual prognosis in patients with vitreomacular traction (VMT).
METHODS: This retrospective study enrolled 31 eyes from 29 patients who underwent vitrectomy for idiopathic VMT with a follow-up period of ≥3 months. The VMT was divided into three grades based on optical coherence tomography images: Grade 1 denoted partial vitreomacular separation with foveal attachment; Grade 2 exhibited intraretinal cysts or cleft with grade 1 findings; and Grade 3 was Grade 2 plus the subretinal fluid.
RESULTS: Three eyes developed a full-thickness macular hole after surgery, all of which were Grade 3 patients. In the rest 28 eyes, the mean postoperative follow-up period was 23.3 ± 25.8 months. The postoperative central foveal thickness ( P = 0.001) and final best-corrected visual acuity (BCVA; P < 0.001) were both significantly improved from baseline. Fifteen eyes (53.8%) gained ≥ two Snellen lines. Multilinear regression analysis showed that the worse the baseline BCVA ( P = 0.004), or the more advanced the VMT grade ( P = 0.049), the worse the final BCVA. Baseline BCVA was negatively associated with the postoperative visual improvement ( P < 0.001). Those Grade 3 patients with baseline Snellen BCVA of ≥20/40 were more likely to achieve a final Snellen BCVA of ≥20/25 ( P = 0.035).
CONCLUSIONS: The VMT grade is an important predictive factor for the postsurgical visual prognosis. Surgical intervention should be performed as early as possible for Grade 3 patients to prevent further disease progression and maximize the postsurgical visual benefit.
METHODS: This retrospective study enrolled 31 eyes from 29 patients who underwent vitrectomy for idiopathic VMT with a follow-up period of ≥3 months. The VMT was divided into three grades based on optical coherence tomography images: Grade 1 denoted partial vitreomacular separation with foveal attachment; Grade 2 exhibited intraretinal cysts or cleft with grade 1 findings; and Grade 3 was Grade 2 plus the subretinal fluid.
RESULTS: Three eyes developed a full-thickness macular hole after surgery, all of which were Grade 3 patients. In the rest 28 eyes, the mean postoperative follow-up period was 23.3 ± 25.8 months. The postoperative central foveal thickness ( P = 0.001) and final best-corrected visual acuity (BCVA; P < 0.001) were both significantly improved from baseline. Fifteen eyes (53.8%) gained ≥ two Snellen lines. Multilinear regression analysis showed that the worse the baseline BCVA ( P = 0.004), or the more advanced the VMT grade ( P = 0.049), the worse the final BCVA. Baseline BCVA was negatively associated with the postoperative visual improvement ( P < 0.001). Those Grade 3 patients with baseline Snellen BCVA of ≥20/40 were more likely to achieve a final Snellen BCVA of ≥20/25 ( P = 0.035).
CONCLUSIONS: The VMT grade is an important predictive factor for the postsurgical visual prognosis. Surgical intervention should be performed as early as possible for Grade 3 patients to prevent further disease progression and maximize the postsurgical visual benefit.
摘要：
目的：探讨玻璃体黄斑牵引(VMT)患者术后视觉预后的预测因素。
方法：这项回顾性研究纳入了29例特发性VMT患者的31只眼，这些患者接受了玻璃体切除术，随访时间≥3个月。根据光学相干断层扫描图像，将VMT分为三个等级：1级表示部分玻璃体黄斑分离并带有中央凹附着；2级表现为1级表现出视网膜内囊肿或裂隙；3级为2级加上视网膜下液。
结果：三只眼睛在手术后出现了全层黄斑裂孔，均为3级患者.其余的28只眼睛，术后平均随访时间为23.3±25.8个月.术后中央凹厚度（P=0.001）和最终最佳矫正视力（BCVA；P<0.001）均较基线显着改善。15只眼睛（53.8％）增加了≥两条Snellen线。多元线性回归分析显示,基线BCVA越差(P=0.004),或VMT等级越先进(P=0.049)，最后的BCVA越差。基线BCVA与术后视力改善呈负相关(P<0.001)。那些基线SnellenBCVA≥20/40的3级患者更有可能达到最终SnellenBCVA≥20/25（P=0.035）。
结论：VMT分级是术后视觉预后的重要预测因素。对于3级患者，应尽早进行手术干预，以防止疾病进一步进展并最大程度地提高术后视觉效益。
方法：这项回顾性研究纳入了29例特发性VMT患者的31只眼，这些患者接受了玻璃体切除术，随访时间≥3个月。根据光学相干断层扫描图像，将VMT分为三个等级：1级表示部分玻璃体黄斑分离并带有中央凹附着；2级表现为1级表现出视网膜内囊肿或裂隙；3级为2级加上视网膜下液。
结果：三只眼睛在手术后出现了全层黄斑裂孔，均为3级患者.其余的28只眼睛，术后平均随访时间为23.3±25.8个月.术后中央凹厚度（P=0.001）和最终最佳矫正视力（BCVA；P<0.001）均较基线显着改善。15只眼睛（53.8％）增加了≥两条Snellen线。多元线性回归分析显示,基线BCVA越差(P=0.004),或VMT等级越先进(P=0.049)，最后的BCVA越差。基线BCVA与术后视力改善呈负相关(P<0.001)。那些基线SnellenBCVA≥20/40的3级患者更有可能达到最终SnellenBCVA≥20/25（P=0.035）。
结论：VMT分级是术后视觉预后的重要预测因素。对于3级患者，应尽早进行手术干预，以防止疾病进一步进展并最大程度地提高术后视觉效益。
