期刊
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
卷 260, 期 10, 页码 3173-3183出版社
SPRINGER
DOI: 10.1007/s00417-022-05672-z
关键词
Cystoid macular edema; Full-thickness macular hole; Traumatic macular hole; Spontaneous closure; Vitreomacular traction; Outer nuclear layer; External limiting membrane; Inner segment of the photoreceptor; Outer segment of the photoreceptor
The purpose of this study was to analyze the recovery course of foveal microstructures in eyes with nonsurgical healing of full-thickness macular hole (FTMH). The results showed that the recovery sequences proceeded from the outer nuclear layer (ONL) to the deeper layers, with best spectacle-corrected visual acuity correlating with the restoration of outer retinal layer integrity.
Purpose To analyze the recovery course of foveal microstructures in eyes with nonsurgical healing of full-thickness macular hole (FTMH). Methods By serial OCT scans, the temporal healing sequences were analyzed in ocular trauma, vitreomacular traction (VMT), cystoid macular edema (CME), and the remaining group. We evaluated correlations between the final best-corrected spectacle visual acuity and reconstruction time of external limiting membrane (ELM), and inner segment/outer segment (IS/OS). Results The healing (mean +/- standard deviation in months) most involved fusion at the level of the outer nuclear layer (ONL) (6.3 +/- 10.5) followed by restoration of ELM (9.1 +/- 13.8), and lastly, by IS/OS regeneration (13.1 +/- 19.5). In severe blunt ocular trauma, healing was fast and involved subretinal zipper glue-like reapposition with resulting outer retinal atrophy. Best spectacle-corrected visual acuity correlated with normalization of the clivus (p=0.012), faster ELM (p=0.006), and IS/OS reconstitution (p=0.024). Recurrence of FTMH occurred when the healing was halted (3 eyes) or was aberrant by lamellar hole epiretinal proliferation (LHEP) (3 eyes) or by the persistence of VMT (1 eye). Conclusion Recovery sequences proceeded from the ONL to the deeper layers with BCVA correlating absolutely and temporally with the restoration of outer retinal layer integrity.
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