Cargando…

Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis

PURPOSE: To assess the efficacy of vitrectomy in degenerative and tractional lamellar macular holes (LMHs) by meta-analysis of published studies. METHODS: PubMed, Medline and Embase databases were searched up to May 2020. Included cohorts were divided into three groups: degenerative LMH group, lamel...

Descripción completa

Detalles Bibliográficos
Autores principales: Parisi, Guglielmo, Fallico, Matteo, Maugeri, Andrea, Barchitta, Martina, Agodi, Antonella, Russo, Andrea, Longo, Antonio, Avitabile, Teresio, Castellino, Niccolò, Bonfiglio, Vincenza, Dell’Omo, Roberto, Furino, Claudio, Cennamo, Gilda, Rejdak, Robert, Nowomiejska, Katarzyna, Toro, Mario, Marolo, Paola, Ventre, Luca, Reibaldi, Michele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935291/
https://www.ncbi.nlm.nih.gov/pubmed/33667237
http://dx.doi.org/10.1371/journal.pone.0246667
_version_ 1783660978157649920
author Parisi, Guglielmo
Fallico, Matteo
Maugeri, Andrea
Barchitta, Martina
Agodi, Antonella
Russo, Andrea
Longo, Antonio
Avitabile, Teresio
Castellino, Niccolò
Bonfiglio, Vincenza
Dell’Omo, Roberto
Furino, Claudio
Cennamo, Gilda
Rejdak, Robert
Nowomiejska, Katarzyna
Toro, Mario
Marolo, Paola
Ventre, Luca
Reibaldi, Michele
author_facet Parisi, Guglielmo
Fallico, Matteo
Maugeri, Andrea
Barchitta, Martina
Agodi, Antonella
Russo, Andrea
Longo, Antonio
Avitabile, Teresio
Castellino, Niccolò
Bonfiglio, Vincenza
Dell’Omo, Roberto
Furino, Claudio
Cennamo, Gilda
Rejdak, Robert
Nowomiejska, Katarzyna
Toro, Mario
Marolo, Paola
Ventre, Luca
Reibaldi, Michele
author_sort Parisi, Guglielmo
collection PubMed
description PURPOSE: To assess the efficacy of vitrectomy in degenerative and tractional lamellar macular holes (LMHs) by meta-analysis of published studies. METHODS: PubMed, Medline and Embase databases were searched up to May 2020. Included cohorts were divided into three groups: degenerative LMH group, lamellar hole associated epiretinal proliferation (LHEP) group and tractional LMH group. LHEP is likely to be associated with degenerative LMHs, but less commonly could be associated with mixed LMHs. To reduce risk of possible misclassification bias, eyes with LHEP which could not have been precisely classified by the authors, were included into the LHEP group. The primary outcome was to investigate the visual change following primary vitrectomy in the degenerative LMH and LHEP group versus the tractional LMH group. A sensitivity analysis excluding the LHEP group was also performed on the primary outcome. Mean difference (MD) in best corrected visual acuity between baseline and post-treatment was calculated, along with 95% confidence interval (CI). Rate of incidence of post-operative full-thickness macular hole (FTMH) was assessed as secondary outcome. RESULTS: Thirteen studies were included. Pooled analyses including all groups showed a significant visual improvement following vitrectomy (pre-post MD = -0.17;95%CI = -0.22,-0.12;p<0.001), with no difference in visual improvement between the degenerative LMH and LHEP group and the tractional LMH group. The sensitivity analysis excluding LHEP group confirmed no difference in visual change between the degenerative LMH group (pre-post MD = -0.18;95%CI = -0.24,-0.12;p<0.001) and the tractional LMH group (MD = -0.16;95%CI = -0.26,-0.07;p<0.001). The incidence rate of post-operative FTMH was higher in the degenerative LMH and LHEP group than in the tractional LMH group (p = 0.002). CONCLUSION: Primary vitrectomy for LMH ensured a favorable visual outcome, with no difference in visual gain between degenerative and tractional LMHs. However, a higher incidence of post-operative FTMHs was found in eyes with the degenerative LMH subtype.
format Online
Article
Text
id pubmed-7935291
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-79352912021-03-15 Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis Parisi, Guglielmo Fallico, Matteo Maugeri, Andrea Barchitta, Martina Agodi, Antonella Russo, Andrea Longo, Antonio Avitabile, Teresio Castellino, Niccolò Bonfiglio, Vincenza Dell’Omo, Roberto Furino, Claudio Cennamo, Gilda Rejdak, Robert Nowomiejska, Katarzyna Toro, Mario Marolo, Paola Ventre, Luca Reibaldi, Michele PLoS One Research Article PURPOSE: To assess the efficacy of vitrectomy in degenerative and tractional lamellar macular holes (LMHs) by meta-analysis of published studies. METHODS: PubMed, Medline and Embase databases were searched up to May 2020. Included cohorts were divided into three groups: degenerative LMH group, lamellar hole associated epiretinal proliferation (LHEP) group and tractional LMH group. LHEP is likely to be associated with degenerative LMHs, but less commonly could be associated with mixed LMHs. To reduce risk of possible misclassification bias, eyes with LHEP which could not have been precisely classified by the authors, were included into the LHEP group. The primary outcome was to investigate the visual change following primary vitrectomy in the degenerative LMH and LHEP group versus the tractional LMH group. A sensitivity analysis excluding the LHEP group was also performed on the primary outcome. Mean difference (MD) in best corrected visual acuity between baseline and post-treatment was calculated, along with 95% confidence interval (CI). Rate of incidence of post-operative full-thickness macular hole (FTMH) was assessed as secondary outcome. RESULTS: Thirteen studies were included. Pooled analyses including all groups showed a significant visual improvement following vitrectomy (pre-post MD = -0.17;95%CI = -0.22,-0.12;p<0.001), with no difference in visual improvement between the degenerative LMH and LHEP group and the tractional LMH group. The sensitivity analysis excluding LHEP group confirmed no difference in visual change between the degenerative LMH group (pre-post MD = -0.18;95%CI = -0.24,-0.12;p<0.001) and the tractional LMH group (MD = -0.16;95%CI = -0.26,-0.07;p<0.001). The incidence rate of post-operative FTMH was higher in the degenerative LMH and LHEP group than in the tractional LMH group (p = 0.002). CONCLUSION: Primary vitrectomy for LMH ensured a favorable visual outcome, with no difference in visual gain between degenerative and tractional LMHs. However, a higher incidence of post-operative FTMHs was found in eyes with the degenerative LMH subtype. Public Library of Science 2021-03-05 /pmc/articles/PMC7935291/ /pubmed/33667237 http://dx.doi.org/10.1371/journal.pone.0246667 Text en © 2021 Parisi et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Parisi, Guglielmo
Fallico, Matteo
Maugeri, Andrea
Barchitta, Martina
Agodi, Antonella
Russo, Andrea
Longo, Antonio
Avitabile, Teresio
Castellino, Niccolò
Bonfiglio, Vincenza
Dell’Omo, Roberto
Furino, Claudio
Cennamo, Gilda
Rejdak, Robert
Nowomiejska, Katarzyna
Toro, Mario
Marolo, Paola
Ventre, Luca
Reibaldi, Michele
Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis
title Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis
title_full Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis
title_fullStr Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis
title_full_unstemmed Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis
title_short Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis
title_sort primary vitrectomy for degenerative and tractional lamellar macular holes: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935291/
https://www.ncbi.nlm.nih.gov/pubmed/33667237
http://dx.doi.org/10.1371/journal.pone.0246667
work_keys_str_mv AT parisiguglielmo primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT fallicomatteo primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT maugeriandrea primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT barchittamartina primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT agodiantonella primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT russoandrea primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT longoantonio primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT avitabileteresio primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT castellinoniccolo primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT bonfigliovincenza primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT dellomoroberto primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT furinoclaudio primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT cennamogilda primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT rejdakrobert primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT nowomiejskakatarzyna primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT toromario primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT marolopaola primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT ventreluca primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis
AT reibaldimichele primaryvitrectomyfordegenerativeandtractionallamellarmacularholesasystematicreviewandmetaanalysis