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Factors predicting normal visual acuity following anatomically successful macular hole surgery
Author(s) -
Fallico Matteo,
Jackson Timothy L.,
Chronopoulos Argyrios,
Hattenbach LarsOlof,
Longo Antonio,
Bonfiglio Vincenza,
Russo Andrea,
Avitabile Teresio,
Parisi Francesca,
Romano Mario,
Fiore Tito,
Cagini Carlo,
Lupidi Marco,
Frisina Rino,
Motta Lorenzo,
Rejdak Robert,
Nowomiejska Katarzyna,
Toro Mario,
Ventre Luca,
Reibaldi Michele
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14575
Subject(s) - medicine , confidence interval , visual acuity , odds ratio , vitrectomy , macular hole , ophthalmology , macular degeneration , surgery , medical record , univariate analysis , retrospective cohort study , multivariate analysis
Purpose To assess the incidence of normal vision following anatomically successful macular hole surgery and associated clinical variables. Methods Multicentre, retrospective chart review. Preoperative, intraoperative and postoperative clinical data were extracted from electronic medical records from seven European vitreoretinal units. Inclusion criteria were as follows: eyes undergoing primary vitrectomy for idiopathic full‐thickness macular hole from January 2015 to January 2018; postoperative macular hole closure confirmed by spectral domain optical coherence tomography (OCT); preoperative pseudophakia or phakic eyes receiving combined cataract surgery; one‐year follow‐up. The primary outcome was ‘normal vision’ defined as a final best‐corrected visual acuity (BCVA) ≥ 20/25. Univariate, multivariate and decision‐tree analyses were conducted to evaluate the clinical variables associated with ‘normal vision’. Odds ratios (OR) and confidence intervals (CIs) were calculated. Results Of 327 eligible cases, 91 (27.8%) achieved ‘normal vision’ at 1 year. Multivariate analysis identified variables significantly associated with ‘normal vision’: shorter symptom duration (odds ratio [OR]=1.05; 95% confidence interval [CI]:1.02‐1.09; p = 0.002), smaller preoperative OCT minimum linear diameter (OR per 100‐micron increase = 1.65; 95%CI:1.31‐2.08; p < 0.001) and better mean preoperative BCVA (OR = 15.13; 95%CI: 3.59‐63.65; p < 0.001). The decision‐tree analysis found that the most significant variable associated with ‘normal vision’ was symptom duration. ‘Normal vision’ was achieved in 70.6% of eyes operated within one week from symptom onset and in 45% of eyes with symptom duration between 1 and 3 weeks. Conclusions These findings suggested urgent surgery is justified for small macular holes of short duration.