PURPOSE:To evaluate the anatomy of idiopathic macular hole (IMH) using Optical Coherence Tomography (OCT) and to construct a prognostic index that can be correlated with the visual outcomes and the anatomical closing. METHODS:Prospective study, in which 22 eyes with IMH had been evaluated through OCT in the daily postoperative period of IMH surgery. The Prognostic of Macular Hole Index (PMHI) was created which was correlated with the anatomical result and the postoperative visual acuity (VA) six months after surgery. RESULTS:Sixteen eyes (72.7%) got anatomical closing at the end of six months of follow-up. On analysis of PMHI, there was significant difference between group 1 (open MH) and group 2 (closed MH) (p=0.0018). The risk for failure of anatomical closing is 11 times greater when the diameter of the internal base is over 600 microm or IPBM is less than 0.6 (p=0.0495). Regarding final VA, it was observed that the IPBM had a significant negative correlation with AV (p=0.001). CONCLUSIONS:IPBM showed to be the best predictor of anatomical closing and postoperative visual acuity among the studied variables. It predicted 41% of the postoperative final visual acuity, leading us to believe that other factors, such as the time of history and the degeneration of photoreceptors in these older BM, can be involved in the visual outcomes.

译文

目的:使用光学相干断层扫描(OCT)评估特发性黄斑裂孔(IMH)的解剖结构,并构建可与视觉结果和解剖闭合相关的预后指标。
方法:一项前瞻性研究,在IMH手术的每日术后期间,通过OCT对22眼IMH进行了评估。黄斑裂孔指数(PMHI)的预后与手术后六个月的解剖结果和术后视力(VA)相关。
结果:六个月的随访结束时有十六只眼(72.7%)在解剖上闭合。在分析PMHI时,第1组(开放式MH)与第2组(封闭式MH)之间存在显着差异(p = 0.0018)。当内部底座的直径超过600微米或IPBM小于0.6(p = 0.0495)时,解剖闭合失败的风险将增加11倍。关于最终的VA,观察到IPBM与AV呈显着负相关(p = 0.001)。
结论:IPBM是研究变量中解剖闭合和术后视敏度的最佳预测指标。它预测了41%的术后最终视敏度,使我们相信其他因素,例如这些较老BM中的病史时间和感光细胞的退化,也可能与视觉结果有关。

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