Foveal Microstructure and Visual Acuity in Surgically Closed Macular Holes: Spectral-Domain Optical Coherence Tomographic Analysis
Foveal Microstructure and Visual Acuity in Surgically Closed Macular Holes: Spectral-Domain Optical Coherence Tomographic Analysis
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DOI：
10.1016/j.ophtha.2010.01.017
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发表时间：
2010-09-01
期刊：
影响因子：
13.7
通讯作者：
Oshima, Yusuke
中科院分区：
文献类型：
--
作者：
Wakabayashi, Taku;Fujiwara, Maiko;Oshima, Yusuke
目的：评估黄斑中心凹微结构的重建变化，并确定与手术闭合黄斑裂孔（MHs.Design）患者视力结果的相关性：回顾性、连续性、观察性病例系列。参会人员：方法：采用光谱域光学相干断层扫描（SD-OCT）技术对手术后3个月和12个月的黄斑中心凹显微结构变化进行评估。评价术后最佳矫正视力（BCVA）与中心凹光感受器层完整性的相关性。主要指标：SD-OCT图像上来自光感受器内段（IS）和外段（OS）交界处以及外界膜（ELM）的背反射线的完整性和当天测量的BCVA。中心凹感光层的完整性是唯一与3个月BCVA显著相关的术后SD-OCT结果（r = 0.483; P = 0.002）。根据IS/OS连接和ELM信号的恢复情况，将患眼分为3组：A组中6只眼（15%）IS/OS连接和ELM完全恢复; B组中26只眼（65%）IS/OS连接中断和ELM完整; C组中8只眼（20%）IS/OS连接和ELM中断或丢失。尽管各组之间的基线BCVA无显著差异（P = 0.137），但A组和B组（均采用重建ELM，有或无恢复的感光细胞IS/OS）的平均3个月BCVA值显著优于C组（P 0.05）。A组（P = 0.029）和B组（P
Purpose: To evaluate reconstructive changes in foveal microstructures and identify a correlation with visual outcomes in eyes with surgically closed macular holes (MHs).Design: Retrospective, consecutive, observational case series. Participants: Forty eyes (40 patients) with surgically closed MHs.Methods: Spectral-domain optical coherence tomography (SD-OCT) was performed to assess the foveal microstructural changes 3 and 12 months postoperatively. The correlation between the postoperative best-corrected visual acuity (BCVA) and the integrity of the foveal photoreceptor layer was evaluated.Main Outcome Measures: The integrity of the back-reflection lines from the photoreceptor inner segment (IS) and outer segment (OS) junction and the external limiting membrane (ELM) on SD-OCT images and the BCVA measured on the same day.Results: The integrity of the foveal photoreceptor layer was the only postoperative SD-OCT finding significantly associated with the 3-month BCVA (r=0.483; P=0.002). The eyes were categorized into 3 groups according to restoration of the IS/OS junction and ELM signals: 6 eyes (15%) in group A with complete restoration of the IS/OS junction and the ELM; 26 eyes (65%) in group B with a disrupted IS/OS junction and intact ELM; and 8 eyes (20%) in group C with disruption or loss of the IS/OS junction and the ELM. Although the baseline BCVA did not differ significantly (P=0.137) among groups, the mean 3-month BCVA values in groups A and B, both with reconstructed ELM with or without a restored photoreceptor IS/OS, were significantly better than in group C (P0.05). Groups A (P=0.029) and B (P