Effect of internal limiting membrane peeling and transplantation on vision-related quality of life in refractory macular hole

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.007

Y. Dongqing, Li Qinghuai, Xie Ping

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引用次数: 0

Abstract

Objective To observe the effect of internal limiting membrane peeling and transplantation on vision-related quality of life in refractory macular hole. Methods A retrospective clinical study. Thirty patients (30 eyes) with refractory macular hole diagnosed in Ophthalmology Department of The First Affiliated Hospital of Nanjing Medical University from January to December 2016 were included in this study. There were 13 males (13 eyes) and 17 females (17 eyes), with the mean age of 57.3±6.9 years. There were 15 patients(15 eyes) with large macular diameter, 12 patients (12 eyes) with high myopia macular hole, and 3 patients (3 eyes) with secondary traumatic macular hole. The BCVA examination was performed using the Snellen visual acuity chart, which was converted into logMAR visual acuity. OCT was performed to measure the macular retinal thickness (CRT), base diameter and minimum diameter of macular hole. Then, the macular hole index(MHI) was calculated. The logMAR BCVA was 1.52±0.30, MHI was 0.51±0.19. The Chinese version of visual-related quality of life scale-25 (CVRQoL-25) was used to evaluate the vision-related quality of life of patients. The CVRQoL-25 score was 57.60±7.13. All patients underwent 23G vitrectomy combined with inner limited membrane peeling and autologous ILM transplantation. The follow-up was at least 3 months after surgery. The changes of BCVA, MHI, CRT and CVRQoL-25 score before and after surgery were comparatively analyzed. Paired t test was performed to compare the measurement data before and after surgery, and Spearman rank correlation analysis was used for the correlation analysis among the parameters. Results At 3 months after surgery, the hole closure was detected in 28 eyes (93.3%), not detected in 2 eyes (6.7%). The logMAR BCVA was 1.16±0.33, CRT was 161.00±15.26, and CVRQoL-25 scores was 70.83±9.77. Compared with before surgery, the BCVA (t=4.386, P=0.000) and CVRQoL-25 score (t=-5.991, P=0.000) after surgery were improved. Spearman rank correlation analysis showed that CVRQoL-25 score was negatively correlated with preoperative and postoperative logMAR BCVA (r=−0.536, −0.796; P=0.002, 0.000); positively correlated with preoperative MHI (r=0.421, P=0.020) and postoperative CRT (r=0.589, P=0.001). Conclusion Internal limiting membrane peeling and transplantation for refractory macular hole can significantly improve the vision-related quality of life and visual acuity, while achieved a high hole closure rate (93.3%). Key words: Retinal perforations/surgery; Vitrectomy; Internal limiting membrane peeling; Internal limiting membrane transplantation; Vision-related quality

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内界膜剥离和移植对难治性黄斑裂孔视力相关生活质量的影响

目的观察内界膜剥离和移植对难治性黄斑裂孔视力相关生活质量的影响。方法回顾性临床研究。本研究纳入了2016年1-12月在南京医科大学附属第一医院眼科诊断的30例（30眼）难治性黄斑裂孔患者。男13例（13只眼），女17例（17只眼），平均年龄57.3±6.9岁。黄斑大直径患者15例（15眼），高度近视黄斑裂孔患者12例（12眼），继发性外伤性黄斑裂孔3例（3眼）。BCVA检查使用Snellen视力表进行，将其转换为logMAR视力。OCT测量黄斑视网膜厚度（CRT）、黄斑裂孔底径和最小直径。然后计算黄斑裂孔指数（MHI）。logMAR BCVA为1.52±0.30，MHI为0.51±0.19。采用中文版视觉相关生活质量量表25（CVRQoL-25）对患者的视觉相关生活品质进行评价。CVRQoL-25评分为57.60±7.13。所有患者均接受了23G玻璃体切除术，结合有限内膜剥离和自体ILM移植。术后随访至少3个月。比较分析手术前后BCVA、MHI、CRT和CVRQoL-25评分的变化。对手术前后的测量数据进行配对t检验比较，参数间的相关性分析采用Spearman秩相关分析。结果术后3个月，28眼（93.3%）检测到闭孔，2眼（6.7%）未检测到，logMAR BCVA为1.16±0.33，CRT为161.00±15.26，CVRQoL-25评分为70.83±9.77。与术前相比，术后BCVA（t=4.386，P=0.000）和CVRQoL-25评分（t=-5.991，P=0.0000）均有改善。Spearman秩相关分析显示，CVRQoL-25评分与术前和术后logMAR BCVA呈负相关（r=-0.536，-0.796；P=0.0002.000）；与术前MHI（r=0.421，P=0.020）和术后CRT（r=0.589，P=0.001）呈正相关；玻璃体切除术；内界膜剥离；内界膜移植；视觉相关质量

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).