Predicting anatomical results of surgical treatment of idiopathic macular hole
Predicting anatomical results of surgical treatment of idiopathic macular hole作者机构：The S. Fyodorov Eye Microsurgery Federal State InstitutionMoscow 127486 Russia
出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)
年 卷 期：2016年第9卷第2期
页 面：253-257页
核心收录：
学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学]
主 题：idiopathic full-thickness macular hole optical coherence tomography anatomical surgery outcome prognosis central subfield retinal thickness receiveroperating characteristic analysis
摘 要：AIM： To determine the parameters most informative in predicting the anatomical results of surgical treatment of idiopathic full-thickness macular hole （IMH）. METHODS： One hundred and sixty-two consecutive patients （170 eyes） after primary operation for IMH were enrolled. Outcomes were classified as anatomical success when both IMH closure and restoration of the outer retinal structure were achieved. ＂Prospective＂ group included 108 patients （115 eyes） followed with optical coherence tomography （OCT） and microperimetry for ly after surgery. Potential prognostic criteria, except microperimetry data, were tested in ＂retrospective＂ group （54 patients, 55 eyes）. Prognostic value of each parameter was determined using receiver operating characteristic （ROC） analysis. Combined predictive power of the best prognostic parameters was tested with the use of linear discriminant analysis. RESULTS： IMH closure was achieved in 106 eyes （92%） in the prospective group and 49 eyes （89%） in the retrospective group. Despite anatomical closure, the outer retinal structure was not restored in two eyes in the first group and in one eye in the second group. Preoperative central subfield retinal thickness demonstrated the best discriminatory capability between eyes with anatomical success and failure： area under the ROC-curve （AUC） 0.938 （95% Ch 0.881-0.995）, sensitivity 64% at fixed specificity 95% （cut-off value 300um） in the prospective group; sensitivity 57% and specificity 90% in the retrospective group. Other continuous parameters except tractional hole index （AUC： 0.796, 95% Ch 0.591- 1.000） had significantly lower AUCs （P〈0.05）. The best combination of the parameters, established by discriminant analysis in the prospective group, could not confirm its predictive value in the retrospective group. CONCLUSION： Preoperative central subfield retinal thickness is a strong and probably the best predictor of anatomical results of IMH surgical treatment.
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