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

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.

The impact of preoperative parameters on postoperative foveal displacement in idiopathic macular hole

“…Moreover, manually defining a range for this calculation adheres to the curved surface characteristics of the hole margins 13 . More significant area parameters, indicative of more vital pulling forces, are associated with larger basal diameters, higher edge of the hole, and relatively lower preoperative visual acuity, consistent with previous findings in the report 24 – 27 . These associations reinforce the concept that area parameters are more reliable indicators of the extent of preoperative traction near the macular hole (MH).…”

Novel Artificial Intelligence-Based Assessment of Imaging Biomarkers in Full-Thickness Macular Holes: Preliminary Data from a Pivotal Trial

“…Joo et al stated that cystic change is considered to be an indicator of functional retinal tissue. The improvement in visual acuity after surgery is attributed to the reduction of retinal cystic fluid, as significant functional retinal tissue remains intact [35]. Ozturk et al conducted an analysis of cyst and MH dimensions, revealing a moderate negative correlation with postoperative BCVA [36].…”

The Importance of Anatomic Configuration and Cystic Changes in Macular Hole: Predicting Surgical Success with a Different Approach

“…In our cases, standard MH surgery procedure was applied in parallel with the other studies, and 20% sulfur hexa uoride was used in all cases. In a recent study conducted by Joo et al [27] investigated the effect of intraretinal cyst speci cations (width, height, diagonal length, angle) on predicting MH closure and showed that intraretinal cyst height was greater in type 1 closure compared to those of type 2 closure. Our results are supported by these studies.…”