A.V. TERESHCHENKO¹, I.G. TRIPHANENKOVA¹, A.A. SHPAK² , N.M. SHILOV¹

¹Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 5 Sv. Fyodorova Str., Kaluga, Russian Federation, 248007

²The S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovsky Blvd, Moscow, Russian Federation, 127486

Tereshchenko A.V. — D. Med. Sc., Director, tel. (4842) 505-767, e-mail: nauka@mntk.kaluga.ru

Triphanenkova I.G. — Cand. Med. Sc., Deputy Director for Science, tel. (4842) 505-767, e-mail: nauka@mntk.kaluga.ru

Shpak A.A. — D. Med. Sc., Professor, Head of the Department of clinical and functional diagnostics, tel. (4842) 505-767, e-mail: nauka@mntk.kaluga.ru

Shilov N.M. — doctor-ophthalmologist, tel. (4842) 505-767, e-mail: nauka@mntk.kaluga.ru

Prognostic criteria for the anatomical result of surgical treatment of large idiopathic macular ruptures using the method of step-by-step formation of the fragment of the internal border membrane were determined. The study included 84 patients (84 eyes) with large idiopathic macular holes, who were performed standard 3-port 25G vitrectomy using the method of step-by-step formation of the fragment of the internal border membrane to close the macular rupture followed by gas voidal tamponade (SF6). As follows from the analysis, it was found that the most informative index of the forecast of the anatomical effect of the operation is the average thickness of the retina in the foveal zone. Less informative were: total light-sensitivity of the retina, the traction index of the rupture and the height of the edge of the macular rupture. The average thickness of the retina in the fovea, measured by the COTT method, is a highly informative indicator of the anatomical prognosis of the surgical treatment of large idiopathic macular ruptures, including ruptures larger than 650 μm. When a mean retina is at least 302 microns thick, in 95% of cases follows a favorable anatomical outcome of surgical treatment in the form of closure of an idiopathic macular rupture with a «defect» at the level of the ellipsoidal photoreceptor zone or complete closure in remote observation periods.

Key words: prognostic criteria, surgical treatment, large macular holes, anatomical results.

REFERENCES

1. Tadayoni R., Gaudric A., Haouchine B., Massin P. Relationship between macular hole size and the potential benefit of internal limiting membrane peeling. Br. J. Ophthalmol, 2006, no. 90, pp. 1239-1241.
2. Ullrich S., Haritoglou C., Gass C. et. al. Macular hole size as a prognostic factor in macular hole surgery. Br. J. Ophthalmol, 2002, vol. 86, no. 4, pp. 390-393.
3. Gupta B., Laidlaw D.A.H., Williamson T.H. et al. Predicting visual success in macular hole surgery. Br. J. Ophthalmol, 2009, vol. 93, no. 11, pp. 1488-1491.
4. Wakely L., Rahman R., Stephenson J. A comparison of several methods of macular hole measurement using optical coherence tomography, and their value in predicting anatomical and visual outcomes. Br. J. Ophthalmol., 2012, no. 96, pp. 1003-1007.
5. Salter A.B., Folgar F.A., Weissbrot J., Wald K.J. Macular hole surgery prognostic success rates based on macular hole size. Ophthalmic Surg Lasers Imaging, 2012, no. 43, pp. 184-189.
6. Kanovsky R., Jurecka T., Gelnarova E. Analysis of prognostic factors of anatomical and functional results of idiopathic macular hole surgery. Cesk. Slov. Oftalmol, 2009, vol. 65, no. 3, pp. 91-96.
7. Shpak A.A., Shkvorchenko D.O., Sharafetdinov I.Kh., Yukhanova O.A. Predicting the results of surgical treatment of idiopathic macular rupture. Oftal’mokhirurgiya, 2015, no. 2, p. 55 (in Russ.).
8. Belyy Yu.A., Tereshchenko A.V., Shkvorchenko D.O. et al. A new technique for the formation of a fragment of the internal border membrane in the surgical treatment of large idiopathic macular ruptures. Oftal’mologiya, 2015, vol. 12, no. 4, pp. 27-33 (in Russ.).
9. Belyy Yu.A., Tereshchenko A.V., Shkvorchenko D.O. et al. A technique for the phased formation of a fragment of the internal border membrane in the surgical treatment of large idiopathic macular orifices. Vestnik oftal’mologii, 2016, vol. 132, no. 1, pp. 23-30 (in Russ.).
10. Shpak A.A., Shkvorchenko D.O., Sharafetdinov I.Kh., Ogorodnikova S.N. et al. Changes in the macular area after endovitral intervention for idiopathic macular rupture. Oftal’mokhirurgiya, 2013, no. 4, p. 78 (in Russ.).
11. Sun Z., Gan D., Jiang C. et al. Effect of Preoperative retinal sensitivity and fixation on long-term prognosis for idiopathic macularholes. Clin Exp Ophthalmol, 2012, vol. 250, no. 11, pp. 1587-96.
12. Haritoglou C., Neubauer A.S., Reiniger I.W. et al. Long-term functional outcome of macular hole surgery correlated to optical coherence tomography measurements. Clin. Exp. Ophthalmol, 2007, vol. 35, no. 3, pp. 208-213.
13. Salter A.B., Folgar F.A., Weissbrot J., Wald K.J. Macular hole surgery prognostic success rates based on macular hole size. Ophthalmic Surg. Lasers Imaging, 2012, vol. 43, no. 3, pp. 184-189.
14. Wakely L., Rahman R., Stephenson J. A comparison of several methods of macular hole measurement using optical coherence tomography and their value in predicting anatomical and visual outcomes. Br. J. Ophthalmol, 2012, vol. 96, no. 7, pp. 1003-1007.
15. Ullrich S., Haritoglou C., Gass C. et al. Macular hole size as a prognostic factor in macular hole surgery. Br. J. Ophthalmol, 2002, vol. 86, no. 4, pp. 390-393.
16. Kusuhara S., Teraoka Eskano M.F., Fujii S. et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am. J. Ophthalmol, 2004, vol. 138, no. 5, pp. 709-716.