Predictors of foveal microstructural reconstruction after idiopathic macular hole surgery

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-03-01 DOI:10.1016/j.pdpdt.2025.104541

Mengqi An , Xiang Zhang , Zetong Nie, Naxin Duan, Chang Liu, Xiaorong Li, Wenbo Li, Bojie Hu

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引用次数: 0

Abstract

Purpose

To identify prediction models and risk factors for anatomical microstructural reconstruction after surgery for idiopathic macular holes (IMHs).

Methods

This retrospective study involved 74 patients (77 eyes) who underwent successful closure after IMH surgery. The conventional MH indicators, macular hole occupancy index (MHOI) and internal limiting membrane (ILM) peeling index were calculated. Binary logistic regression analysis was used to identify prognostic factors and establish predictive models.

Results

The early postoperative anatomy of the inner segment/outer segment (IS/OS) showed a significant correlation with the MHOI, macular hole index (MHI), and traction hole index (THI) (P = 0.018, P = 0.047, P = 0.002, at-1-month; P = 0.008, P = 0.014, P = 0.005, at-3-months). Poorer preoperative best-corrected visual acuity (BCVA) (β = 2.954, P = 0.002) and larger inferior ILM peeling index (IIPI) (β = 7.446, P = 0.006) predicted poorer IS/OS prognosis. The early postoperative continuity of external limiting membrane (ELM) was significantly associated with the MHOI(P = 0.005), diameter hole index (DHI) (P = 0.031), MHI (P = 0.004), and THI (P < 0.001). Larger IIPI (β = 8.490, P = 0.004 at-1-month) and poorer preoperative BCVA (β = 3.665, P = 0.001, at-1-month; β = 4.342, P = 0.002, at-3-months) were independent risk factors. Outer nuclear layer (ONL) disruption was significantly predicated by poorer preoperative BCVA (β = -2.781, P = 0.019) and larger IIPI (β = -5.653, P = 0.061). IS/OS and ELM integrity correlated with early postoperative BCVA, whereas the ONL showed sustained significance over 6 months.

Conclusion

MHOI, MHI, and THI influenced the repair of the IS/OS, ELM, and ONL in the short-term. Preoperative BCVA and IIPI were crucial for long-term prognosis of foveal microstructure. Foveal microstructure integrity is closely related to postoperative visual function recovery.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.