Functional and structural outcomes after vitrectomy: The role of macular contour restoration

Anatomical Outcomes of Traumatic Macular Hole Surgery: Role of OCT Parameters and ILM Flap Techniques

Larger hole dimensions were associated with poorer visual prognosis, whereas greater HH was associated with anatomical closure, and flap-assisted ILM techniques may improve anatomical success in TMH surgery.

Stage of Epiretinal Membrane and Central Bouquet Abnormalities: Key Predictors of Visual Acuity After Vitrectomy.

Clinical and morphological predictors of visual outcomes following inverted internal limiting membrane flap surgery for large macular holes

Purpose: The purpose of the study was to evaluate the anatomical and functional outcomes of the inverted internal limiting membrane (ILM) flap technique in patients with large macular holes (MHs) and identify independent prognostic factors that predict post-operative visual acuity. Methods: This retrospective study included 48 eyes of 48 patients who underwent pars plana vitrectomy and inverted ILM flap technique for idiopathic MHs ≥400 μm. Pre-operative and post-operative best-corrected visual acuity (BCVA), swept-source optical coherence tomography (SS-OCT) parameters, and various clinical factors were evaluated. Multivariate regression analysis was performed to identify independent prognostic factors for the post-operative BCVA. Results: The mean BCVA improved significantly from 1.27±0.41 logMAR preoperatively to 0.62±0.37 logMAR at 6 months postoperatively (p<0.001). U-shaped closure was associated with better BCVA than V-and W-shaped closures (p=0.001). Patients with symptom duration ≤6 months and complete post-operative restoration of the external limiting membrane (ELM) and ellipsoid zone demonstrated significantly better BCVA (p<0.01). Pre-operative BCVA (β=0.637, p<0.001) and MH index (MHI) (β=−0.261, p=0.029) were significant independent determinants of post-operative BCVA. Conclusion: The inverted ILM flap technique provides high anatomical closure rates and significant visual improvement in large MH surgery. Pre-operative BCVA and MHI were significant independent prognostic factors for post-operative visual outcomes. Structural SS-OCT parameters can be clinically useful in predicting post-operative functional outcomes

Postoperative OCT Microstructural Changes as Predictors of Visual Prognosis Following Epiretinal Membrane Peeling: A Retrospective Study.

AIM Idiopathic macular epiretinal membrane (iERM) induces traction and deformation of the macular retina, significantly impairing function and quality of life. This study aimed to evaluate the predictive value of early postoperative optical coherence tomography (OCT) microstructural changes for visual prognosis in patients undergoing vitrectomy with membrane peeling for iERM. METHODS A total of 110 patients diagnosed with iERM at Huzhou Aier Eye Hospital between January 2021 and July 2024 were retrospectively enrolled. According to OCT findings, patients were divided into stage I (n = 38), stage II (n = 52), and stage III (n = 20). All patients underwent 23-gauge minimally invasive vitrectomy combined with indocyanine green staining and peeling of the epiretinal membrane and internal limiting membrane. Best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), choroidal thickness at 1000 μm from the nasal side of the macular fovea (NFCT), and choroidal thickness at 1000 μm from the temporal side of the macular fovea (TFCT) were assessed before surgery and at 1 and 3 months postoperatively. Repeated-measures analysis of variance was used to compare intergroup differences over time, and multivariate logistic regression was performed to identify indicators associated with a favorable visual prognosis. RESULTS Significant gradient differences were observed among the three groups in CMT, SFCT, NFCT, TFCT, and BCVA, with stage I patients exhibiting significantly lower values than those in stage II and stage III (all p < 0.05). During postoperative follow-up, OCT parameters and visual acuity improved in all groups, with significantly greater improvement in stage I patients compared with stage II or stage III (all p < 0.05). Repeated-measures analysis demonstrated a significant time × group interaction effect for CMT (F = 2.334, p = 0.032), with a greater rate of CMT reduction in stage I patients. At 6 months postoperatively, 71 patients (64.55%) achieved a favorable visual prognosis. Multivariate logistic regression analysis indicated that lower CMT at 1 month postoperatively (OR = 0.98, 95% CI: 0.97-0.99, p < 0.05) was significantly associated with favorable visual outcomes at 6 months. CONCLUSIONS Postoperative anatomical and functional recovery in iERM patients is stage-dependent. Lower CMT at 1 month after surgery is significantly associated with favorable visual outcomes at 6 months, suggesting its potential value as an early postoperative prognostic indicator. These findings underscore the importance of incorporating early postoperative OCT assessment into clinical follow-up to facilitate individualized prognosis and patient counseling.

Association Between Epiretinal Membrane-Induced Retinal Traction and the Natural Course of Lamellar Macular Hole.

PURPOSE To evaluate the effect of epiretinal membrane (ERM)-induced retinal traction on functional and anatomical changes of lamellar macular hole (LMH). METHODS This retrospective study included patients with LMH followed for at least 12 months without surgery. Best-corrected visual acuity (BCVA), M-CHARTS-assessed metamorphopsia, and optical coherence tomography (OCT) parameters were evaluated. ERM-induced retinal traction was assessed using B-scan and en face OCT images, with maximum depth of retinal folds (MDRF) quantified as an indicator of retinal traction strength. Annual rates of change in visual function and OCT parameters were compared between eyes with and without ERM-induced retinal traction. RESULTS Thirty-six eyes were analyzed. During a mean follow-up of 46.4 ± 28.4 months, BCVA and metamorphopsia worsened, accompanied by foveal cavity enlargement, increased epiretinal proliferation thickness and ellipsoid zone disruption length, and decreased minimum retinal thickness (all P < 0.05). Eyes with ERM-induced retinal traction demonstrated significantly faster functional and anatomical deterioration than those without traction. MDRF showed significant correlations with worsening rates of BCVA, metamorphopsia, foveal cavity enlargement, and retinal thinning. CONCLUSION ERM-induced retinal traction was associated with accelerated functional and anatomical deterioration in LMH. Quantitative assessment of retinal traction may facilitate the identification of LMH at higher risk of progression.

Preoperative structural and electrophysiological markers associated with visual outcome after idiopathic epiretinal membrane surgery.