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Characteristics and outcomes of full-thickness macular holes created during vitrectomy for proliferative diabetic retinopathy

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Abstract

Purpose

To investigate the clinical features, management, and prognosis of full-thickness macular holes (FTMHs) inadvertently created during vitrectomy for eyes with proliferative diabetic retinopathy (PDR) and fibrovascular proliferation (FVP).

Methods

Eyes with PDR and FVP that had intraoperatively created FTMHs were retrospectively collected as the study group, and age- and sex-matched subjects with PDR and FVP who did not have intraoperative FTMHs were selected as the control group. Fundus abnormalities, optical coherence tomography (OCT) features, and anatomical and functional outcomes were compared between the two groups.

Results

Eleven eyes of 11 patients (5 male and 6 female) were identified as the study group. Follow-up duration was 36.8 ± 47.2 months. FTMHs were managed by ILM peeling or the inverted ILM flap technique. Anatomical success and MH closure were achieved in 100% of eyes in the study group. In comparison to the control group, the study group had a higher proportion of condensed prefoveal tissue (63.6% vs. 22.7%, p = 0.028), and a higher ratio of silicone oil tamponade (63.6% vs. 18.2%, p = 0.014), whereas there were no differences in preoperative and final BCVA, and the severity, activity, and locations of FVP between the two groups.

Conclusion

Condensed prefoveal tissue was a risk factor of FTMHs created during operation for eyes with PDR and FVP. The ILM peeling or the inverted ILM flap technique may be beneficial for the treatment with favorable anatomical and functional outcomes.

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Data availability

Data will be available under reasonable request to the corresponding author.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

    Mei-Chi Tsui & Chung-May Yang

  2. Department of Ophthalmology, An Nan Hospital, China Medical University, Tainan, Taiwan

    Mei-Chi Tsui

  3. Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan

    Chung-May Yang

  4. Department of Ophthalmology, National Taiwan University Hospital Yunlin Branch, No.579, Sec. 2, Yunlin Rd., Douliou, Yunlin, Taiwan

    Lu-Chun Wang

Authors
  1. Mei-Chi Tsui
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Contributions

MCT wrote the main manuscript text and prepared Figs. 1–4. All authors reviewed the manuscript.

Corresponding author

Correspondence to Lu-Chun Wang.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was approved by the Research Ethics Committee of National Taiwan University Hospital and was conducted in accordance with the Declaration of Helsinki.

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Consent to participate was exempted by the Research Ethics Committee of National Taiwan University Hospital since this is a retrospective study.

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Tsui, MC., Yang, CM. & Wang, LC. Characteristics and outcomes of full-thickness macular holes created during vitrectomy for proliferative diabetic retinopathy. Int Ophthalmol 43, 3479–3490 (2023). https://doi.org/10.1007/s10792-023-02753-8

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  • DOI: https://doi.org/10.1007/s10792-023-02753-8

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