Evaluation of the recurrence risk of macular hole in the high myopia after removing silicone oil by spectral domain optical coherence tomography / 中华实验眼科杂志

ABSTRACT

Background Macular hole in high myopia has been paid tremendous attention in clinical research due to its high recurrence rate and unpredictable prognosis.Spectral domain optical coherence tomography (SD-OCT) is considered to be of a good evaluating value for macular hole,yet its application is compromised in patient with high myopia.High myopia might lead to retinal detachment which consequently prevents an accurate OCT.Therefore,it is important to assess the effectiveness of OCT on prognosis in these patients after surgical restoration of the detached retina.Objective The aim of this study was to evaluate the risk of reopening of a macular hole in highly myopic patient after removing silicone oil by SD-OCT.Methods A case-observational study was designed.Twenty-five highly myopic patients with monocular macular holes who underwent vitrectomy combined with internal limiting membrane peeling and silicone oil tamponade were included in this study.Four patients were male and 21 patients were female,with the average age (61.4±9.0) years old and diopter (-14.14 ±6.86)D.Regular ocular examination,axial length measurement,fundus photography and OCT were performed at the day before removing silicone oil and every month till the 6 months after operation.Retinal thickness,macular height index (MHI) and choroidal thickness were measured by OCT.Written informed consent was obtained from each patient.Results All 25 patients finished the follow-up of 6 months.Macular holes remained closure 6 months after operation in 19 patients (76％) and reopened in 6 patients macular holes were in 1-5 months (24％),with a mean time at (3.3± 1.4) months.The average foveal retinal thickness,MHI and the choroidal thickness at the middle of the macular hole were (216.5±95.6) μm,0.30 ± 0.09 and (122.9 ± 20.5) μm in the closed group,respectively,and those in the unclosed group were (113.5±28.7) μm,0.58±0.27 and (96.8±22.9) μm,with significant differences between the two groups (t=2.577,-4.143,2.669,P ＜ 0.05).The percentage of macular hole closure was 85.7％ in the MHI＜0.5 group and 25.0％ in the MHI ≥ 0.5 group,showing a significant difference (P =0.031).The base diameter in the unclosed hole group was significantly larger than that in the closed hole group (1070.2±393.6 μm versus 533.3±277.7 μm) (t =-3.700,P =0.001).Conclusions The measurements of the retinal thickness,MHI and the choroidal thickness at the central area of the macular hole are helpful for the evaluation of reopening risk of macular hole after removing silicone oil.