ObjectiveTo observe outcome of visual acuity and photoreceptor inner segment (IS)/outer segment (OS) changes in idiopathic macular hole (IMH) patients after micro-invasive vitrectomy. MethodsForty patients (40 eyes) with idiopathic macular hole underwent micro-invasive vitrectomy were enrolled in this study. The patients included 12 males and 28 females, with an average age of (62.43±5.68) years, with an average course of 2.78 months. All the patients were examined for best corrected visual acuity (BCVA), intraocular pressure, slit lamp ophthalmoscopy combine with preset lens, fundus color photography and optical coherence tomography (OCT) examination.The BCVA was converted to logarithm of the minimal angle of resolution (logMAR).The BCVA was 0.05-0.5, with an average log MAR BCVA of 0.71±0.19. The average diameter of minimum macular hole was (410.13±175.72) μm. The average base diameter of maximum macular hole was (775.00±264.77) μm. The diameter of IS/OS defect was 618-2589 μm, with an average of (1682.08±484.11) μm. There were 4, 16, 20 eyes with stage Ⅱ, Ⅲ, Ⅳ macular hole, respectively. The follow-up period was 33.75 months. BCVA and macular structure at month 1, 3 and the final follow-up after surgery were analyzed. The correlation among logMAR BCVA,diameter of IS/OS defect at final follow-up and the follow-up time was analyzed. ResultsThe mean logMAR BCVA at month 1, 3 and the final follow-up after surgery were 0.49±0.31, 0.37±0.26, 0.30±0.26 respectively. Compared with the mean preoperative logMAR BCVA, the differences were significant (Z=-4.598, -5.215, -5.218; P<0.05). The preoperative logMAR BCVA and the diameter of minimum macular hole were significantly correlated with the postoperative logMAR BCVA at final follow-up (r=0.401, 0.392, P<0.05). The preoperative diameter of IS/OS defect and the postoperative diameter of IS/OS defect at final follow-up were significantly correlated with the postoperative logMAR BCVA at final follow-up (r=0.339, 0.353; P<0.05). The time of final follow-up was not correlated with the postoperative logMAR BCVA and the diameter of IS/OS defect at final follow-up (r=0.000, 0.018; P>0.05). At the final follow-up, the macular holes were totally closed in 39 eyes (97.5%). Thirty-two eyes exhibited a complete recovery of IS/OS junction, 8 eyes continued to exhibit an IS/OS junction defect. ConclusionMicro-invasive vitrectomy can stabilize vision of IMH patients, and promote complete recovery of IS/OS.
Objective o compare the differences in the choroidal thickness at 1500 μm nasal or temporal to the fovea between three measurements of different imaging modes. Methods In this retrospective study, 21 eyes from 20 patients diagnosed with central serous chorioretinopathy (CSC), whose retinas tilt over 5.0 degree to the horizontal line were included (retina tilt group). The control group (retinal horizontal group) also included 21 eyes from 20 individuals whose retinas are horizontal indicated by retinal tilt angle measurement. There were no statistical significance (t=0.00, -0.345, 0.489; P＞0.05) in gender, age and spherical equivalent distributions between the two groups. The choroidal thickness at 1500 μm nasal or temporal to the fovea was measured by spectral-domain optical coherence tomography (COT) enhanced depth scanning under three modes (1∶1 pixel, 1∶1 micron and continuous measurement). The differences of choroidal thickness between these three measure modes were analyzed by a paired t test. Results The choroidal thickness was (304.81±87.74), (342.86±91.43), (307.86±89.35) μm respectively measured by 1∶1 pixel, 1∶1 micron and continuous measurement modes in retinal tilt group. The choroidal thickness measured by 1∶1 pixel was increased compare to that by 1∶1 micron, the difference was statistically significant (t=-8.499, P＜0.01). The choroidal thickness measured by continuous measurement mode was the same of that by 1∶1 micron, the difference was not statistically significant (t=-0.790, P＞0.05). In retinal horizontal group, the choroidal thickness measured by these 3 modes was the same, the difference was not statistically significant (t=-1.521, -1.822; P＞0.05). Conclusions Spectralis OCT with 1∶1 pixel mode exhibits horizontally compressed image, the values of choroidal thickness under tilted retinas measured by this condition were significantly greater than the true ones. The choroidal thickness measured by 1∶1 micron mode measurement is more accurate. Continuous measurement mode provides more accurate and convenient choroidal thickness measurement during follow up of patients.