Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes
IntroductionInverted Internal Limiting Membrane (ILM)-flap technique demonstrated its effectiveness, in terms of anatomical closure rate and visual acuity recovery for high myopic macular holes. We evaluated macular function after a successful inverted ILM-flap for macular holes in high myopic eyes...
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Frontiers Media S.A.
2023-11-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1276502/full |
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| author | Alessandra Sborgia Giacomo Boscia Giacomo Boscia Alfredo Niro Luca Landini Valentina Pastore Valeria Albano Marina Piepoli Rossella Donghia Stefano Dore Pasquale Viggiano Rosa Buonamassa Camilla Di Pardo Teresa Molfetta Eye Clinic Research Group Marco Coassin Roberto Dell’Omo Francesco Boscia Giovanni Alessio Giancarlo Sborgia Antonella Guglielmi Giacomo Scotti Marida Gaudiomonte Roberto Semeraro |
| author_facet | Alessandra Sborgia Giacomo Boscia Giacomo Boscia Alfredo Niro Luca Landini Valentina Pastore Valeria Albano Marina Piepoli Rossella Donghia Stefano Dore Pasquale Viggiano Rosa Buonamassa Camilla Di Pardo Teresa Molfetta Eye Clinic Research Group Marco Coassin Roberto Dell’Omo Francesco Boscia Giovanni Alessio Giancarlo Sborgia Antonella Guglielmi Giacomo Scotti Marida Gaudiomonte Roberto Semeraro |
| author_sort | Alessandra Sborgia |
| collection | DOAJ |
| description | IntroductionInverted Internal Limiting Membrane (ILM)-flap technique demonstrated its effectiveness, in terms of anatomical closure rate and visual acuity recovery for high myopic macular holes. We evaluated macular function after a successful inverted ILM-flap for macular holes in high myopic eyes (hMMH) using microperimetry to predict visual prognosis.MethodsA retrospective study on 23 eyes of 23 patients after surgical closure of hMMH, was performed. All patients underwent inverted ILM-flap and gas tamponade. Cataract surgery was performed in phakic eyes. Study outcomes including best-corrected visual acuity (BCVA), retinal sensitivity (RS) at central 12°, central retinal sensitivity (CRS) at central 4° and mean deviation (MD), and fixation behavior as bivariate contour ellipse area (BCEA, degrees2) measured by microperimetry, were evaluated over 6 months. A mixed-effects model was used to evaluate and compare the repeated measurements of outcomes between phakic and pseudophakic eyes. A regression model was performed to assess the relationship between BCVA at 6 months and independent variables.ResultsOverall mean BCVA improved from 0.98 ± 0.21 logMAR at baseline to 0.47 ± 0.31 logMAR at the last follow-up (p < 0.001). Over 6 months, overall sensitivity measurements improved (RS, p = 0.001; CRS, p < 0.0001; MD, p = 0.03), and the BCEA decreased in dimension, although not significantly (p ≥ 0.05). The mixed model revealed a significantly better effect of inverted ILM-flap combined with cataract surgery on BCVA and CRS in phakic eyes than inverted ILM-flap alone in pseudophakic ones. The regression model revealed a relationship of 6-month BCVA with pre-operative BCVA (β = 0.60, p = 0.02) and RS (β = −0.03, p = 0.01).ConclusionThe inverted ILM-flap technique significantly improved visual acuity and retinal sensitivity after the hMMH closure, particularly when combined with cataract extraction. Pre-operative visual acuity and retinal sensitivity at central 12° may predict post-surgical visual acuity. |
| first_indexed | 2024-03-10T01:16:41Z |
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| language | English |
| last_indexed | 2024-03-10T01:16:41Z |
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| spelling | doaj.art-fbdb8963a33e451990c48da6993a04c72023-11-23T14:08:06ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-11-011010.3389/fmed.2023.12765021276502Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyesAlessandra Sborgia0Giacomo Boscia1Giacomo Boscia2Alfredo Niro3Luca Landini4Valentina Pastore5Valeria Albano6Marina Piepoli7Rossella Donghia8Stefano Dore9Pasquale Viggiano10Rosa Buonamassa11Camilla Di Pardo12Teresa Molfetta13Eye Clinic Research Group14Marco Coassin15Roberto Dell’Omo16Francesco Boscia17Giovanni Alessio18Giancarlo Sborgia19Antonella GuglielmiGiacomo ScottiMarida GaudiomonteRoberto SemeraroDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyEye Clinic Section, Department of Surgical Sciences, University of Turin, Turin, ItalyEye Clinic, “SS. Annunziata” Hospital, ASL Taranto, Taranto, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyNational Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Bari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyOphthalmology, University Campus Bio Medico of Rome, Roma, ItalyDepartment of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyDepartment of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, ItalyIntroductionInverted Internal Limiting Membrane (ILM)-flap technique demonstrated its effectiveness, in terms of anatomical closure rate and visual acuity recovery for high myopic macular holes. We evaluated macular function after a successful inverted ILM-flap for macular holes in high myopic eyes (hMMH) using microperimetry to predict visual prognosis.MethodsA retrospective study on 23 eyes of 23 patients after surgical closure of hMMH, was performed. All patients underwent inverted ILM-flap and gas tamponade. Cataract surgery was performed in phakic eyes. Study outcomes including best-corrected visual acuity (BCVA), retinal sensitivity (RS) at central 12°, central retinal sensitivity (CRS) at central 4° and mean deviation (MD), and fixation behavior as bivariate contour ellipse area (BCEA, degrees2) measured by microperimetry, were evaluated over 6 months. A mixed-effects model was used to evaluate and compare the repeated measurements of outcomes between phakic and pseudophakic eyes. A regression model was performed to assess the relationship between BCVA at 6 months and independent variables.ResultsOverall mean BCVA improved from 0.98 ± 0.21 logMAR at baseline to 0.47 ± 0.31 logMAR at the last follow-up (p < 0.001). Over 6 months, overall sensitivity measurements improved (RS, p = 0.001; CRS, p < 0.0001; MD, p = 0.03), and the BCEA decreased in dimension, although not significantly (p ≥ 0.05). The mixed model revealed a significantly better effect of inverted ILM-flap combined with cataract surgery on BCVA and CRS in phakic eyes than inverted ILM-flap alone in pseudophakic ones. The regression model revealed a relationship of 6-month BCVA with pre-operative BCVA (β = 0.60, p = 0.02) and RS (β = −0.03, p = 0.01).ConclusionThe inverted ILM-flap technique significantly improved visual acuity and retinal sensitivity after the hMMH closure, particularly when combined with cataract extraction. Pre-operative visual acuity and retinal sensitivity at central 12° may predict post-surgical visual acuity.https://www.frontiersin.org/articles/10.3389/fmed.2023.1276502/fullhigh myopiamacular holeinverted ILM-flapmicroperimetryretinal sensitivityfixation behavior |
| spellingShingle | Alessandra Sborgia Giacomo Boscia Giacomo Boscia Alfredo Niro Luca Landini Valentina Pastore Valeria Albano Marina Piepoli Rossella Donghia Stefano Dore Pasquale Viggiano Rosa Buonamassa Camilla Di Pardo Teresa Molfetta Eye Clinic Research Group Marco Coassin Roberto Dell’Omo Francesco Boscia Giovanni Alessio Giancarlo Sborgia Antonella Guglielmi Giacomo Scotti Marida Gaudiomonte Roberto Semeraro Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes Frontiers in Medicine high myopia macular hole inverted ILM-flap microperimetry retinal sensitivity fixation behavior |
| title | Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes |
| title_full | Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes |
| title_fullStr | Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes |
| title_full_unstemmed | Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes |
| title_short | Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes |
| title_sort | microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane flap technique for macular hole in high myopic eyes |
| topic | high myopia macular hole inverted ILM-flap microperimetry retinal sensitivity fixation behavior |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1276502/full |
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