Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 3;22(1):5.
doi: 10.1186/s12886-021-02204-x.

Role of intraretinal cysts in the prediction of postoperative closure and photoreceptor damages of the idiopathic full-thickness macular hole

Jin-Ho Joo  1 , Woo Ho Nam  2 , Taesung Joo  1 , Sang Woong Moon  3
Affiliations

Role of intraretinal cysts in the prediction of postoperative closure and photoreceptor damages of the idiopathic full-thickness macular hole

Jin-Ho Joo et al. BMC Ophthalmol. .

Abstract

Background: To determine whether it would be effective in predicting the results of the postoperative full-thickness macular hole (FTMH) closure when intraretinal cyst (IRC) is present.

Methods: Case-control study. Patients with idiopathic FTMH who underwent pars plana vitrectomy with internal limiting membrane peeling were retrospectively reviewed. Preoperative spectral-domain optical coherence tomography was undertaken in all patients. The new parameter, macular hole closing factor (MHCF) was defined as the base diameter - (arm length + IRC height) by adding IRC to the existing parameter. After surgery, patients were classified and analyzed according to the type of hole closure and the damage of photoreceptor.

Results: Of the 35 patients, 28 (80.00%) had type 1 closure and seven (20.00%) had type 2 closure. There was a significant difference in postoperative BCVA (P < 0.01), base diameter (P = 0.037), arm length (P = 0.045), and IRC height (P = 0.011) between the two groups. In the type 1 closure, they were further divided into two subgroups according to photoreceptor damage, and it was confirmed that there were significant differences in postoperative BCVA (P = 0.045), hole height (P = 0.048), and IRC height (P = 0.046) in the two subgroups. As for the new parameters, a significant difference between the three groups was confirmed (P < 0.01).

Conclusion: IRC may help predict hole closure along with the known horizontal parameters. Therefore, the new parameter containing both two factors can help predict not only hole closure but also damage to photoreceptors that affects postoperative visual prognosis.

Keywords: Hole closure; Intraretinal cyst; Macular hole; Macular hole closing factor; Photoreceptor damages.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Preoperative parameters of macular hole on spectral domain optical coherence tomography
Fig. 2
Fig. 2
Graph showing difference of parameters of spectral domain optical coherence tomography for 3 sub-group; intact foveal photoreceptor type 1 closure (n = 13), damaged foveal photoreceptor type 1 closure (n = 14), and type 2 closure (n = 7). The Mann-Whitney test was used, and p values less than 0.05 were marked with an asterisk (*). (T1: type 1 closure, T2: type 2 closure, PhRc: photoreceptor)
Fig. 3
Fig. 3
Receiver operating characteristic (ROC) curves obtained for parameters of spectral domain optical coherence tomography as prognostic factor for distinguishing the closure type of FTMH (A) and whether the photoreceptor is intact in type 1 closed FTMH (B)
See this image and copyright information in PMC

References

    1. Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis. Archives of ophthalmology (Chicago, Ill : 1960) 1988;106(5):629–639. doi: 10.1001/archopht.1988.01060130683026. - DOI - PubMed
    1. Smiddy WE, Flynn HW., Jr Pathogenesis of macular holes and therapeutic implications. Am J Ophthalmol. 2004;137(3):525–537. doi: 10.1016/j.ajo.2003.12.011. - DOI - PubMed
    1. Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, Sadda SR, Sebag J, Spaide RF, Stalmans P. The international Vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120(12):2611–2619. doi: 10.1016/j.ophtha.2013.07.042. - DOI - PubMed
    1. Uchino E, Uemura A, Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Archives of Ophthalmology (Chicago, Ill : 1960) 2001;119(10):1475–1479. doi: 10.1001/archopht.119.10.1475. - DOI - PubMed
    1. Koizumi H, Spaide RF, Fisher YL, Freund KB, Klancnik JM, Jr, Yannuzzi LA. Three-dimensional evaluation of vitreomacular traction and epiretinal membrane using spectral-domain optical coherence tomography. Am J Ophthalmol. 2008;145(3):509–517. doi: 10.1016/j.ajo.2007.10.014. - DOI - PubMed