Prognostic factors for development of gliosis after internal limited membrane flap for idiopathic macular holes.

IF 2.1 2区医学 Q2 OPHTHALMOLOGY

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2025-09-10 DOI:10.1097/IAE.0000000000004685

Edward Barayev, Mor Krubiner, Timna Leshchinski, Alon Tiosano, Orly Gal-Or, Jerzy Nawrocki, Zofia Anna Nawrocka, Rita Ehrlich

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Abstract

Purpose: To investigate the prognostic factors for development of gliosis after idiopathic macular hole (IMH) surgery, and its relationship to functional and anatomical success.

Methods: This retrospective study included patients with IMH that underwent PPV using internal limiting membrane (ILM) flap technique. OCT examinations were done at baseline, 1 month and 6 months postoperatively. Postoperative parameters on OCT included hole closure, outer retinal layers continuity and development of gliosis.

Results: Sixty-five patients with IMH were included in the study. Forty-three underwent temporal flap and 22 an inverted flap 360° around the hole. Gliosis was present at 8 (12.3%) eyes at 1 and 6 months postoperatively. Patients with gliosis at 6 months had larger minimal hole diameter at presentation (622µm ± 140 vs 423 ± 178, p=0.004). Gliosis was associated with worse BCVA at presentation (0.86± 0.49 logMAR (20/145) vs 0.43 ± 0.37 (20/54), p=0.008) and 1 month postoperatively (0.91 ± 0.59 logMAR (20/160) vs 0.42 ± 0.48 (20/53), p=0.013) but not at 6 months postoperatively (0.55 ± 0.31 logMAR (20/70) vs 0.43 ± 0.33 (20/54), p=0.222).

Conclusion: Our study supports the use of inverted ILM flap for IMH as a primary procedure. No gliosis was shown in small macular holes undergoing this technique. Even in large IMH where gliosis has developed, an improvement in visual acuity was shown after surgery.

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特发性黄斑孔内限定膜瓣术后胶质瘤发生的预后因素。

目的：探讨特发性黄斑孔（IMH）手术后神经胶质瘤发生的预后因素及其与功能和解剖成功的关系。方法：本回顾性研究包括采用内限制膜（ILM）皮瓣技术行PPV的IMH患者。分别于基线、术后1个月和6个月进行OCT检查。术后OCT参数包括孔洞闭合、视网膜外层连续性和胶质瘤的发生。结果：65例IMH患者纳入研究。43例行颞部皮瓣，22例行360°逆行皮瓣。术后1个月和6个月有8只眼（12.3%）出现神经胶质瘤。6个月时出现神经胶质瘤的患者就诊时最小孔直径较大（622µm±140 vs 423±178,p=0.004）。胶质瘤出现时与BCVA恶化相关(0.86±0.49 logMAR (20/145) vs 0.43±0.37 (20/54),p=0.008)，术后1个月(0.91±0.59 logMAR (20/160) vs 0.42±0.48 (20/53),p=0.013)，但术后6个月无相关(0.55±0.31 logMAR （20/70) vs 0.43±0.33 (20/54),p=0.222）。结论：我们的研究支持将内翻内膜瓣作为IMH的主要手术。该技术未发现小黄斑孔内出现胶质细胞增生。即使在发生神经胶质瘤的大IMH中，手术后视力也有所改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.