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A new method to predict anatomical outcome after idiopathic macular hole surgery

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether a new macular hole closure index (MHCI) could predict anatomic outcome of macular hole surgery.

Methods

A vitrectomy with internal limiting membrane peeling, air-fluid exchange, and gas tamponade were performed on all patients. The postoperative anatomic status of the macular hole was defined by spectral-domain OCT.

MHCI was calculated as (M+N)/BASE based on the preoperative OCT status. M and N were the curve lengths of the detached photoreceptor arms, and BASE was the length of the retinal pigment epithelial layer (RPE layer) detaching from the photoreceptors. Postoperative anatomical outcomes were divided into three grades: A (bridge-like closure), B (good closure), and C (poor closure or no closure). Correlation analysis was performed between anatomical outcomes and MHCI. Receiver operating characteristic (ROC) curves were derived for MHCI, indicating good model discrimination. ROC curves were also assessed by the area under the curve, and cut-offs were calculated. Other predictive parameters reported previously, which included the MH minimum, the MH height, the macular hole index (MHI), the diameter hole index (DHI), and the tractional hole index (THI) had been compared as well.

Results

MHCI correlated significantly with postoperative anatomical outcomes (r = 0.543, p = 0.000), but other predictive parameters did not. The areas under the curves indicated that MHCI could be used as an effective predictor of anatomical outcome. Cut-off values of 0.7 and 1.0 were obtained for MHCI from ROC curve analysis. MHCI demonstrated a better predictive effect than other parameters, both in the correlation analysis and ROC analysis.

Conclusions

MHCI could be an easily measured and accurate predictive index for postoperative anatomical outcomes.

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Acknowledgments

This work was supported by a grant from the National Science and Technology Major Project (2011ZX09302-007-02). Co-corresponding author: Xiaoxin Li, Department of Ophthalmology, Peking University People’s Hospital, Xizhimen South Street 11, Xi Cheng District, 100044 Beijing, China. Telephone number: +861088325413. E-mail address: dr_lixiaoxin@163.com

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Peking University People’s Hospital, Xizhimen South Street 11, Xi Cheng District, 100044, Beijing, China

    Peipei Liu, Yaoyao Sun, Dan Song, Yanrong Jiang, Jianhong Liang, Hong Yin, Xiaoxin Li & Mingwei Zhao

  2. Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China

    Peipei Liu, Yaoyao Sun, Dan Song, Yanrong Jiang, Jianhong Liang, Hong Yin, Xiaoxin Li & Mingwei Zhao

  3. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China

    Chongya Dong

Authors
  1. Peipei Liu
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  2. Yaoyao Sun
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  3. Chongya Dong
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  4. Dan Song
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  5. Yanrong Jiang
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  7. Hong Yin
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  8. Xiaoxin Li
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  9. Mingwei Zhao
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Corresponding author

Correspondence to Mingwei Zhao.

Additional information

The first two authors contributed equally to this work.

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Liu, P., Sun, Y., Dong, C. et al. A new method to predict anatomical outcome after idiopathic macular hole surgery. Graefes Arch Clin Exp Ophthalmol 254, 683–688 (2016). https://doi.org/10.1007/s00417-015-3116-x

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  • DOI: https://doi.org/10.1007/s00417-015-3116-x

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