PDF(Pubmed)
Abstract：
Purpose: To characterize the change in visual acuity (VA) in eyes treated with vitrectomy using the 2020 international consensus-based optical coherence tomography (OCT) definition of lamellar macular hole (LMH), macular pseudohole (MPH), and epiretinal membrane with foveoschisis (ERMF). Methods: A retrospective chart review was performed from 2000 to 2022 of patients who had vitrectomy for symptomatic decreased VA from LMH, MPH, or ERMF performed by the same surgeon at a community hospital. Preoperative spectral domain (SD-OCT) was reviewed to classify patients using the consensus guidelines. Primary outcomes were the mean change in best-corrected VA at 3 months, 1 year, and the final postoperative examination. Results: Fifty-one patients were included, 30 with LMH, 14 with MPH, and 7 with ERMF. The VA was 20/63 at baseline, 20/62 (P = .79) 3 months postoperatively, 20/40 (P = .003) at 1 year, and 20/52 (P = .10) at the final examination for LMH; 20/64, 20/50 (P = .16), 20/40 (P = .040), and 20/40 (P = .02), respectively, for MPH; and 20/53, 20/50 (P = .42), 20/30 (P = .03), and 20/38 (P = .04), respectively, for ERMF. Subgroup analysis showed that eyes with LMH without ellipsoid zone (EZ) disruption on SD-OCT improved from 20/57 at baseline to 20/39 (P = .01) at the final examination. Conclusions: There was no significant improvement in VA at the final postvitrectomy examination in eyes with LMH, while there was significant improvement in eyes with MPH and ERMF. This supports surgery in selected eyes with MPH and ERMF but possibly not in eyes with LMH, unless OCT shows no EZ disruption.
摘要：
目的：使用2020年国际共识光学相干断层扫描（OCT）对板层黄斑孔（LMH）的定义，表征玻璃体切除术治疗的眼睛的视力（VA）变化，黄斑假孔（MPH），和视网膜前膜伴视网膜前裂（ERMF）。方法：回顾性分析2000年至2022年因LMH引起的症状性VA降低而进行玻璃体切除术的患者，MPH,或由同一外科医生在社区医院执行的ERMF。术前谱域（SD-OCT）进行审查，以使用共识指南对患者进行分类。主要结果是3个月时最佳校正VA的平均变化，1年,以及最后的术后检查。结果：纳入51例患者，30与LMH，14与MPH，7与ERMF。基线时VA为20/63，20/62（P=0.79）术后3个月，20/40（P=0.003）在1年，和20/52（P=.10）在LMH的期末考试中；20/64，20/50（P=.16），20/40（P=.040），和20/40（P=.02），分别,对于MPH；和20/53，20/50（P=.42），20/30（P=.03），和20/38（P=.04），分别,对于ERMF。亚组分析显示，在SD-OCT上没有椭球区（EZ）破坏的LMH眼睛从基线时的20/57改善到最终检查时的20/39（P=0.01）。结论：在LMH患者的最终玻璃体切除术后检查中，VA没有显着改善，而MPH和ERMF的眼睛有显著改善。这支持在患有MPH和ERMF的选定眼睛中进行手术，但在患有LMH的眼睛中可能不支持手术。除非OCT未显示EZ中断。
