Academic Journal
OCT-Defined Foveal Restoration Is Associated with Visual Recovery after Vitrectomy for Lamellar Macular Hole: A Multicenter Study: LMH Report No. 1.
| Τίτλος: | OCT-Defined Foveal Restoration Is Associated with Visual Recovery after Vitrectomy for Lamellar Macular Hole: A Multicenter Study: LMH Report No. 1. |
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| Συγγραφείς: | Fukushima M; Department of Ophthalmology, Kindai University Faculty of Medicine, Sakai-shi, Japan; Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan., Akai R; Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Department of Ophthalmology, Takaoka City Hospital, Takaoka-shi, Japan., Inoue R; Department of Ophthalmology, Akita University, Akita City, Japan., Matoba R; Department of Ophthalmology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama City, Japan., Ando T; Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Goto H; Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Japan., Funatsu R; Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan., Wakabayashi T; Wakabayashi Eye Center, Nonoichi, Japan., Kato T; Department of Ophthalmology, Takaoka City Hospital, Takaoka-shi, Japan., Maruyama K; Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan., Hayashi A; Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan., Kusaka S; Department of Ophthalmology, Kindai University Faculty of Medicine, Sakai-shi, Japan., Iwase T; Department of Ophthalmology, Akita University, Akita City, Japan., Morizane Y; Department of Ophthalmology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama City, Japan., Terashima H; Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Akagi T; Department of Ophthalmology, Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Miyata K; Miyata Eye Hospital, Miyazaki, Japan., Mori Y; Miyata Eye Hospital, Miyazaki, Japan., Kubota N; Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Japan., Okamoto F; Department of Ophthalmology, Nippon Medical School, Bunkyo-Ku, Japan., Terasaki H; Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan., Kamei M; Department of Ophthalmology, Aichi Medical University, Aichi, Japan., Tsuboi K; Department of Ophthalmology, Aichi Medical University, Aichi, Japan; Tsuboi Eye Center, Nishi-ku, Japan. Electronic address: kotarotsuboi@gmail.com. |
| Συλλογικό Έργο: | LMH Study Group |
| Πηγή: | Ophthalmology. Retina [Ophthalmol Retina] 2026 Sep; Vol. 10 (9), pp. 932-943. Date of Electronic Publication: 2026 Jun 01. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Published by Elsevier Inc. on behalf of American Academy of Ophthalmology Country of Publication: United States NLM ID: 101695048 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-6530 (Electronic) Linking ISSN: 24686530 NLM ISO Abbreviation: Ophthalmol Retina Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Published by Elsevier Inc. on behalf of American Academy of Ophthalmology, [2017]- |
| Ιατρικοί όροι (MeSH): | Vitrectomy*/methods , Retinal Perforations*/surgery , Retinal Perforations*/diagnosis , Retinal Perforations*/physiopathology , Tomography, Optical Coherence*/methods , Fovea Centralis*/diagnostic imaging , Fovea Centralis*/pathology , Recovery of Function*/physiology , Visual Acuity*, Humans ; Retrospective Studies ; Female ; Male ; Follow-Up Studies ; Aged ; Middle Aged |
| Περίληψη: | Purpose: Anatomic restoration after vitrectomy for lamellar macular hole (LMH) is not always achieved. However, the impact of unresolved LMH on visual outcomes remains unclear. We evaluated postoperative outcomes in eyes with unresolved LMH and postoperative full-thickness macular hole (FTMH) to reassess the meaning of anatomic success after LMH surgery. Design: Multicenter, retrospective cohort study. Subjects: One hundred sixty-six consecutive eyes of 166 patients who underwent vitrectomy for LMH. Methods: Anatomic success was defined as restoration of foveal configuration, whereby the postoperative OCT findings no longer met the diagnostic criteria for LMH. Postoperative anatomic outcomes were classified as anatomic success, unresolved LMH (including both persistent or recurrent LMH), or postoperative FTMH. Main Outcome Measures: Incidence and risk factors of unresolved LMH and postoperative FTMH, and best-corrected visual acuity (BCVA). Results: Anatomic success was achieved in 141 eyes (84.9%), whereas 14 eyes (8.4%) had unresolved LMH and 11 eyes (6.6%) progressed to FTMH during follow-up (mean, 17.8 months). At 12 months, BCVA was significantly worse in eyes with unresolved LMH than in those with anatomic success (0.24 ± 0.24 vs. 0.09 ± 0.19 logarithm of the minimum angle of resolution [LogMAR]; P = 0.041). Internal limiting membrane (ILM) peeling was significantly associated with a reduced risk of unresolved LMH (odds ratio [OR], 0.011; 95% confidence interval [CI], 0.002-0.062; P < 0.001). Postoperative FTMH was significantly associated with epiretinal proliferation (P = 0.018), thinner preoperative central foveal thickness (P = 0.017), and no ILM peeling (P = 0.001). Multivariable analysis confirmed that ILM peeling was an independent factor preventing postoperative FTMH (OR, 0.080; 95% CI, 0.010-0.620; P = 0.001). Postoperative FTMH achieved closure in 9 eyes (82%) with additional treatment or observation, whereas the final BCVA was significantly worse in eyes that developed FTMH than in those with anatomic success (0.50 ± 0.32 vs. 0.12 ± 0.20 LogMAR; P < 0.001). Conclusions: Although most eyes achieved anatomic success after vitrectomy for LMH, approximately 15% developed unresolved LMH or postoperative FTMH, both of which were associated with the absence of ILM peeling. Because anatomic failure was associated with poorer visual outcomes, foveal restoration on OCT may represent a more clinically meaningful anatomic endpoint after LMH surgery. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. (Copyright © 2026 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Investigator: M Fukushima; R Akai; R Inoue; R Matoba; T Ando; H Goto; R Funatsu; T Wakabayashi; T Kato; K Maruyama; A Hayashi; S Kusaka; T Iwase; Y Morizane; H Terashima; T Akagi; K Miyata; Y Mori; N Kubota; F Okamoto; H Terasaki; M Kamei; K Tsuboi Keywords: Epiretinal proliferation; Full-thickness macular hole; Internal limiting membrane peeling; Lamellar macular hole; Pars plana vitrectomy. |
| Entry Date(s): | Date Created: 20260602 Date Completed: 20260902 Latest Revision: 20260911 |
| Update Code: | 20260912 |
| DOI: | 10.1016/j.oret.2026.05.015 |
| PMID: | 42229849 |
| Βάση Δεδομένων: | MEDLINE |
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