Disorganization of Retinal Inner Layers and Ellipsoid Zone Disruption Predict Visual Outcomes in Central Retinal Vein Occlusion

et al. 2020

BMC Ophthalmol

Background: Given the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery. Method: Publications up to July 2020 that compared the surgical outcomes of lamellar macular hole with and without LHEP were included. Forest plots were created by using a weighted summary of proportion meta-analysis. Fixed or random effects models were used on the basis of I2 heterogeneity estimates. Meanwhile, to evaluate the stability of the meta-analysis, a sensitivity analysis was carried out. Results: Eight pertinent publications that contained a total of 176 eyes without LHEP and 173 eyes with LHEP were included. They were all retrospective studies and had a follow-up of at least 6 months. In all studies, the preoperative best corrected visual acuity showed no significant differences between the two groups, and the visual acuity improved in both groups after surgery. The pooled result for the improved best corrected visual acuity was 0.18 (95% confidence interval (CI), 0.10 to 0.26; P < 0.01) between the with and without LHEP groups. The restored ellipsoid zone odds ratio was 0.80 (95% CI, 0.26 to 2.44; P = 0.69) for the group with LHEP compared to the group without LHEP. Conclusion: Patients without LHEP had better postoperative visual acuity than patients with LHEP. No significant difference in restored ellipsoid zone was found between the two groups.

Section: Discussioncontrasting

confidence: 89%

Surgery outcomes of lamellar macular eyes with or without lamellar hole-associated epiretinal proliferation: a meta-analysis

et al. 2020

BMC Ophthalmol

“…As there are no signi cant differences in preoperative BCVA (<20/40), surgery method (ILM and ERM peeling) and time of follow-up (>6 months) among these two kinds of studies, more studies with longer follow-up are required to determine the relationship between the poor visual outcomes and LHEP. Though many studies have reported the positive association between the REZ and postoperative BVCA [25,26], no signi cant differences of REZ existed between with and without LHEP groups in present study. Previous studies reported that although the defection of ellipsoid zone before surgery was associated with worse postoperative BCVA, its restoration showed no direct association with functional recover [5,27].…”

Section: Discussioncontrasting

confidence: 73%

Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis

et al. 2020

Preprint

Background: Given the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery.Method: Publications up to July 2020 that compared the surgical outcomes of lamellar macular hole with and without LHEP were included. Forest plots were created by using a weighted summary of proportion meta-analysis. Fixed or random effects models were used on the basis of I2 heterogeneity estimates. Meanwhile, to evaluate the stability of the meta-analysis, a sensitivity analysis was carried out.Results: Eight pertinent publications that contained a total of 176 eyes without LHEP and 173 eyes with LHEP were included. They were all retrospective studies and had a follow-up of at least 6 months. In all studies, the preoperative best corrected visual acuity showed no significant differences between the two groups, and the visual acuity improved in both groups after surgery. The pooled result for the improved best corrected visual acuity was 0.18 (95% confidence interval (CI), 0.10 to 0.26; P< 0.01) between the with and without LHEP groups. The restored ellipsoid zone odds ratio was 0.80 (95% CI, 0.26 to 2.44; P= 0.69) for the group with LHEP compared to the group without LHEP.Conclusion: Patients without LHEP had better postoperative visual acuity than patients with LHEP. No significant difference in restored ellipsoid zone was found between the two groups.

“…Hence, it can be concluded that more patients with LHEP gained ellipsoid zone restoration, while had worse postoperative BCVA. Though many studies have reported the positive association between the REZ and postoperative BVCA [20,21], higher rate of REZ and lower postoperative BVCA appeared in present study. This phenomenon may can be explained by previous studies, which reported that though the defection of ellipsoid zone before surgery was associated with worse postoperative BCVA, its restoration showed no direct association with functional recover [5,22].…”

Section: Discussioncontrasting

confidence: 62%

Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis

et al. 2019

Preprint

Background: To compare the visual outcomesand rate of restored ellipsoid zone (REZ) after surgery of lamellar macular hole (LMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). To determine whether all patients with LMH need surgery. Method: Publications up to November 2019 that compared the outcomes of LMH patients with and without LHEP who were managed by surgery were included. Forest plots were created using a weighted summary of proportion meta-analysis. A random effects mode was used and I2 heterogeneity estimates were calculated. Sensitivity analysis was carried out to evaluate the stability of the meta-analysis. Result: Four pertinent publications studying a total of 157 patients were identified. They were all retrospective studies and had a mean follow-up of at least 6 months. In all studies, the best corrected visual acuity (BCVA) had no significant differences before surgery and improved in both groups, and in two studies the post-operative BCVA had no significant differences between two groups. The rate of REZ were different among studies included. Meta-analytic pooling of the improved BCVA between with and without LHEP groups was 0.15 (95 % CI, 0.02 to 0.27; p=0.02), and the pooled data revealed an odd ratio of 5.79 (95% CI, 1.15 to 29.18; p = 0.03) in the rate of restored ellipsoid zone, comparing the group without LHEP and the group with LHEP. Patients with LHEP were more likely to gain restored ellipsoid zone after surgery but had lower postoperative BCVA. The surgery of LMH with LHEP appeared to be useless for improving visual acuity.