Clinical Characteristics and Surgical Outcomes of the Full-thickness Macular Hole Without Focal Vitreomacular Traction: A Multicenter Retrospective Study.
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Abstract
Purpose: This study investigated the clinical features and surgical outcomes of full-thickness macular holes (FTMHs) without focal vitreomacular traction (VMT) and discusses possible underlying mechanisms.
Methods: This was a retrospective observational study included patients aged 18 years or older with stage 2 FTMHs who underwent pars plana vitrectomy at three hospitals between December 2016 and March 2024. Patients diagnosed without focal VMT in the macula were classified as VMT- and those with focal VMT were classified as VMT+. Medical records and comprehensive ophthalmologic examinations, including best-corrected visual acuity (BCVA) and optical coherence tomography assessments, were reviewed.
Results: This study analyzed 94 eyes that underwent surgery for stage 2 MHs. Patients in the VMT- were younger (VMT- vs VMT+: 63.6 vs 69.1 years, P = 0.008), had a longer axial length (AL) (25.2 vs 24.0 mm, P = 0.004), and had better preoperative BCVA [0.41 (20/43) vs 0.66 (20/74) logMAR, P = 0.002 ] compared with the VMT+. The VMT- had a higher prevalence of epiretinal proliferation (EP) compared with the VMT+ (76 vs 5 %, P<0.001). Postoperatively, no significant difference in visual outcomes was found between the two groups . VMT- showed significantly thicker central retinal thickness at 1 month (244 vs 201 μm, P = 0.021) and poorer external limiting membrane status at 1 month compared with the VMT+.
Conclusions: FTMHs without focal VMT were associated with younger age, longer AL, better baseline visual acuity, and a higher incidence of EP compared with FTMHs with VMT.
目的：探讨无局灶性玻璃体黄斑牵引（VMT）的全层黄斑孔（FTMHs）的临床特征和手术效果，并探讨可能的机制。方法：这是一项回顾性观察性研究，纳入了2016年12月至2024年3月在三家医院接受玻璃体切割手术的18岁及以上2期ftmh患者。诊断为黄斑无局灶性VMT的患者分为VMT-型，有局灶性VMT的患者分为VMT+型。回顾了医疗记录和综合眼科检查，包括最佳矫正视力（BCVA）和光学相干断层扫描评估。结果：本研究分析了94只接受2期MHs手术的眼睛。VMT-组患者更年轻（VMT- vs VMT+: 63.6 vs 69.1岁，P = 0.008），轴向长度（AL）更长（25.2 vs 24.0 mm, P = 0.004），术前BCVA更好[0.41 (20/43)vs 0.66 (20/74) logMAR, P = 0.002]。VMT-与VMT+相比，VMT-有更高的视网膜前增生（EP）患病率（76% vs 5%）。结论：无局灶性VMT的ftmh与合并VMT的ftmh相比，年龄更年轻，AL更长，基线视力更好，EP发生率更高。
期刊介绍：
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