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Quantitative analysis of external limiting membrane, ellipsoid zone and interdigitation zone defects in patients with macular holes

  • Retinal Disorders
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Abstract

Purpose

To investigate the correlation between the length of external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) defects and visual prognosis in patients undergoing macular hole (MH) surgery, using spectral-domain optical coherence tomography (SD-OCT).

Methods

This is a retrospective, consecutive, observational case series study. Fifty-two eyes of 52 patients with primary MH were evaluated. A quantitative analysis of ELM, EZ and IZ defects was performed preoperatively and at 3 and 6 months postoperatively using SD-OCT. The correlation between pre- and postoperative ELM, EZ and IZ defects and the best-corrected visual acuity (BCVA) was investigated.

Results

The lengths of ELM, EZ and IZ defects correlated significantly with BCVA in each study period (P < 0.001). Preoperative measures of these band defects were also associated with visual outcomes 3 and 6 months after surgery (P < 0.05). Considering all preoperative parameters, the length of the ELM defect was the factor most strongly correlated with BCVA at 6 months (β = 0.643, P < 0.012). The integrity of the ELM was the only factor significantly associated with BCVA at 6 months (β = 0.427; P = 0.004).

Conclusions

The preoperative length of the ELM defect is the strongest predictor of visual acuity after MH surgery. Postoperative integrity of the ELM is significantly associated with visual restoration after surgical treatment of MH.

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Authors and Affiliations

  1. Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Jacques Ramos Houly, Carlos Eduardo Veloso, Elke Passos & Márcio Bittar Nehemy

  2. Instituto da Visão, 881 dos Otoni Street - 13th floor, Belo Horizonte, MG, 30150-270, Brazil

    Jacques Ramos Houly, Carlos Eduardo Veloso, Elke Passos & Márcio Bittar Nehemy

Authors
  1. Jacques Ramos Houly
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  2. Carlos Eduardo Veloso
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  3. Elke Passos
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  4. Márcio Bittar Nehemy
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Correspondence to Jacques Ramos Houly.

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Funding

No funding was received for this research.

Conflict of interest

Jacques Houly, Carlos Veloso and Elke Passos 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. Márcio B. Nehemy has received speaker support from Bayer, Novartis and Allergan.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Houly, J.R., Veloso, C.E., Passos, E. et al. Quantitative analysis of external limiting membrane, ellipsoid zone and interdigitation zone defects in patients with macular holes. Graefes Arch Clin Exp Ophthalmol 255, 1297–1306 (2017). https://doi.org/10.1007/s00417-017-3636-7

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  • DOI: https://doi.org/10.1007/s00417-017-3636-7

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