Prognostic Factor Analysis of Vitrectomy for Retinal Detachment Associated with Myopic Macular Holes
To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure. Retrospective case series. All patient...
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| Published in | Ophthalmology (Rochester, Minn.) Vol. 121; no. 1; pp. 305 - 310 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.01.2014
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0161-6420 1549-4713 1549-4713 |
| DOI | 10.1016/j.ophtha.2013.08.033 |
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| Abstract | To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure.
Retrospective case series.
All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center.
Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates.
Retinal reattachment and complete anatomic success (retinal reattachment with MH closure).
In total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was −9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3F8) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002–1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08–106.29; P = 0.04).
Vitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3F8 are associated with a greater likelihood of anatomic success. |
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| AbstractList | To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure.
Retrospective case series.
All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center.
Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates.
Retinal reattachment and complete anatomic success (retinal reattachment with MH closure).
In total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was -9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3F8) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002-1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08-106.29; P = 0.04).
Vitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3F8 are associated with a greater likelihood of anatomic success. To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure. Retrospective case series. All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center. Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates. Retinal reattachment and complete anatomic success (retinal reattachment with MH closure). In total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was −9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3F8) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002–1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08–106.29; P = 0.04). Vitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3F8 are associated with a greater likelihood of anatomic success. To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure.PURPOSETo describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure.Retrospective case series.DESIGNRetrospective case series.All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center.PARTICIPANTSAll patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center.Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates.METHODSCase records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates.Retinal reattachment and complete anatomic success (retinal reattachment with MH closure).MAIN OUTCOME MEASURESRetinal reattachment and complete anatomic success (retinal reattachment with MH closure).In total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was -9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3F8) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002-1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08-106.29; P = 0.04).RESULTSIn total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was -9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3F8) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002-1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08-106.29; P = 0.04).Vitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3F8 are associated with a greater likelihood of anatomic success.CONCLUSIONSVitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3F8 are associated with a greater likelihood of anatomic success. Purpose To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole (MH) and to analyze the prognostic and surgical factors predicting retinal reattachment and MH closure. Design Retrospective case series. Participants All patients who underwent vitrectomy for RD resulting from myopic MH between 2000 and 2009 at our center. Methods Case records were reviewed at 6 months after surgery. Retinal reattachment and complete anatomic success, defined as retinal reattachment with MH closure, were assessed. Multivariate logistic regression models, including age, gender, duration of symptoms, spherical equivalent refraction (SE), internal limiting membrane peeling, tamponade choice, and concurrent scleral buckling, were constructed to assess associations with covariates. Main Outcome Measures Retinal reattachment and complete anatomic success (retinal reattachment with MH closure). Results In total, 114 subjects were analyzed. Most were women (n = 79 [69.3%]), and the mean age was 57.5±13.3 years. The mean SE was −9.88±6.37 diopters. At 6 months, 98 subjects (86.0%) demonstrated retinal reattachment, of whom 93 subjects required only 1 operation. Complete anatomic success was achieved in 61 subjects (53.5%), of whom 55 needed only 1 operation. Subjects with retinal reattachment had better best-corrected visual acuity (BCVA; mean BCVA, 1.22±0.81 logarithm of the minimum angle of resolution [logMAR] units) than those without (mean BCVA, 1.98±1.26 logMAR units; P < 0.001), and subjects with complete anatomic success had better BCVA (mean BCVA, 1.05±0.87 logMAR units) than those without (mean BCVA, 1.62±0.87 logMAR units; P < 0.001). In multivariate analyses, increasing age and the use of perfluoropropane (C3 F8 ) tamponade were predictive of anatomic success (per 1-year increase: odds ratio [OR], 1.049; 95% confidence interval [CI], 1.002–1.099; P = 0.04; and for tamponade: OR, 10.71; 95% CI, 1.08–106.29; P = 0.04). Conclusions Vitrectomy is effective in the repair of RD resulting from MH in myopic eyes, with retinal reattachment achieved more frequently than MH closure. Retinal reattachment and MH closure are important for improving visual outcomes. Greater age at presentation and use of C3 F8 are associated with a greater likelihood of anatomic success. |
| Author | Ong, Sze Guan Loh, Boon Kwang Lee, Shu Yen Tsai, Andrew Ang, Chong Lye Yeo, Ian Wong, Doric Lim, Laurence Shen Wong, Edmund |
| Author_xml | – sequence: 1 givenname: Laurence Shen surname: Lim fullname: Lim, Laurence Shen organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 2 givenname: Andrew surname: Tsai fullname: Tsai, Andrew organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 3 givenname: Doric surname: Wong fullname: Wong, Doric organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 4 givenname: Edmund surname: Wong fullname: Wong, Edmund organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 5 givenname: Ian surname: Yeo fullname: Yeo, Ian organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 6 givenname: Boon Kwang surname: Loh fullname: Loh, Boon Kwang organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 7 givenname: Chong Lye surname: Ang fullname: Ang, Chong Lye organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 8 givenname: Sze Guan surname: Ong fullname: Ong, Sze Guan organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore – sequence: 9 givenname: Shu Yen surname: Lee fullname: Lee, Shu Yen email: lee.shu.yen@snec.com.sg organization: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24139155$$D View this record in MEDLINE/PubMed |
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| Copyright | 2014 American Academy of Ophthalmology American Academy of Ophthalmology Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
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| Snippet | To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic macular hole... Purpose To describe the anatomic and functional outcomes in a cohort of subjects undergoing vitrectomy for retinal detachment (RD) resulting from myopic... |
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| SubjectTerms | Endotamponade Female Follow-Up Studies Humans Male Middle Aged Myopia, Degenerative - complications Ophthalmology Prognosis Retina - physiopathology Retinal Detachment - diagnosis Retinal Detachment - etiology Retinal Detachment - surgery Retinal Perforations - diagnosis Retinal Perforations - etiology Retinal Perforations - surgery Retrospective Studies Visual Acuity - physiology Vitrectomy |
| Title | Prognostic Factor Analysis of Vitrectomy for Retinal Detachment Associated with Myopic Macular Holes |
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