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Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery
PURPOSE: The purpose of this study was to develop methods to model the external limiting membrane (ELM) and ellipsoid zone (EZ) within the elevated cuff surrounding a macular hole (MH) to determine if the predicted size of the defect in these layers after virtual flattening was associated with the a...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Association for Research in Vision and Ophthalmology
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054630/ https://www.ncbi.nlm.nih.gov/pubmed/34003987 http://dx.doi.org/10.1167/tvst.10.4.7 |
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author | Baumann, Carmen Iannetta, Danilo Sultan, Ziyaad Pearce, Ian A. Lohmann, Chris P. Zheng, Yalin Kaye, Stephen B. |
author_facet | Baumann, Carmen Iannetta, Danilo Sultan, Ziyaad Pearce, Ian A. Lohmann, Chris P. Zheng, Yalin Kaye, Stephen B. |
author_sort | Baumann, Carmen |
collection | PubMed |
description | PURPOSE: The purpose of this study was to develop methods to model the external limiting membrane (ELM) and ellipsoid zone (EZ) within the elevated cuff surrounding a macular hole (MH) to determine if the predicted size of the defect in these layers after virtual flattening was associated with the actual postoperative defect and best-corrected visual acuity (BCVA). METHODS: Patients were included who had undergone successful MH surgery. The defects in the ELM and EZ after virtual flattening were modeled using in-house software. Main outcomes were postoperative defects in ELM and EZ at 2 months and BCVA at 12 months. RESULTS: Fifty-eight patients were included. BCVA improved from 0.87 (0.31) logMAR pre-operatively to 0.26 (0.21) at 12 months (P < 0.001). For both the ELM and EZ, the predicted virtually flattened pre-operative defects were associated with the actual postoperative defects at 2 months (R(2) = 0.33, P < 0.01 and R(2) = 0.50, P < 0.01, respectively). There was a significant association of BCVA at 12 months (adjusted R(2) = 0.85) with the pre-operative modeled area of the defect in the ELM (P < 0.01) and to a lesser extent with the defect in the EZ (P < 0.01) and base of the MH (P < 0.01). CONCLUSIONS: Virtually flattening of the pre-operative defect in the ELM provides important predictive information of visual acuity. Incorporation of tools into commercially available optical coherence tomography (OCT) devices to facilitate such measurements would provide the clinician with important prognostic information. TRANSLATIONAL RELEVANCE: We have developed methodology that can potentially be used to predict the postoperative state of the outer retinal layers and the associated visual outcome in patients undergoing surgery for MH. |
format | Online Article Text |
id | pubmed-8054630 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Association for Research in Vision and Ophthalmology |
record_format | MEDLINE/PubMed |
spelling | pubmed-80546302021-05-05 Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery Baumann, Carmen Iannetta, Danilo Sultan, Ziyaad Pearce, Ian A. Lohmann, Chris P. Zheng, Yalin Kaye, Stephen B. Transl Vis Sci Technol Article PURPOSE: The purpose of this study was to develop methods to model the external limiting membrane (ELM) and ellipsoid zone (EZ) within the elevated cuff surrounding a macular hole (MH) to determine if the predicted size of the defect in these layers after virtual flattening was associated with the actual postoperative defect and best-corrected visual acuity (BCVA). METHODS: Patients were included who had undergone successful MH surgery. The defects in the ELM and EZ after virtual flattening were modeled using in-house software. Main outcomes were postoperative defects in ELM and EZ at 2 months and BCVA at 12 months. RESULTS: Fifty-eight patients were included. BCVA improved from 0.87 (0.31) logMAR pre-operatively to 0.26 (0.21) at 12 months (P < 0.001). For both the ELM and EZ, the predicted virtually flattened pre-operative defects were associated with the actual postoperative defects at 2 months (R(2) = 0.33, P < 0.01 and R(2) = 0.50, P < 0.01, respectively). There was a significant association of BCVA at 12 months (adjusted R(2) = 0.85) with the pre-operative modeled area of the defect in the ELM (P < 0.01) and to a lesser extent with the defect in the EZ (P < 0.01) and base of the MH (P < 0.01). CONCLUSIONS: Virtually flattening of the pre-operative defect in the ELM provides important predictive information of visual acuity. Incorporation of tools into commercially available optical coherence tomography (OCT) devices to facilitate such measurements would provide the clinician with important prognostic information. TRANSLATIONAL RELEVANCE: We have developed methodology that can potentially be used to predict the postoperative state of the outer retinal layers and the associated visual outcome in patients undergoing surgery for MH. The Association for Research in Vision and Ophthalmology 2021-04-13 /pmc/articles/PMC8054630/ /pubmed/34003987 http://dx.doi.org/10.1167/tvst.10.4.7 Text en Copyright 2021 The Authors https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License. |
spellingShingle | Article Baumann, Carmen Iannetta, Danilo Sultan, Ziyaad Pearce, Ian A. Lohmann, Chris P. Zheng, Yalin Kaye, Stephen B. Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery |
title | Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery |
title_full | Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery |
title_fullStr | Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery |
title_full_unstemmed | Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery |
title_short | Predictive Association of Pre-Operative Defect Areas in the Outer Retinal Layers With Visual Acuity in Macular Hole Surgery |
title_sort | predictive association of pre-operative defect areas in the outer retinal layers with visual acuity in macular hole surgery |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054630/ https://www.ncbi.nlm.nih.gov/pubmed/34003987 http://dx.doi.org/10.1167/tvst.10.4.7 |
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