Residual sub-Retinal fluid after idiopathic macular hole repair surgery is not visually significant and resolves within 6 months

摘要

Purpose : Sub-retinal fluid (SRF) has been observed after successful macular hole repair (MHR) although the significance is uncertain and pre-operative risk factors for ita??s development are unknown. Our aim was to determine if BCVA is affected by the presence of SRF, and to elucidate any possible preclinical predictive values. Methods : A retrospective chart review was performed on all patients between June 2014 and November 2015 who underwent MHR for idiopathic macular hole (MH) via pars-plana vitrectomy, membrane-peel, and air-fluid exchange with SF6 gas by a single surgeon. Patients with less than 6 months of follow-up, traumatic MH, or MH associated with retinal detachments were excluded. Patient demographics, BCVA at each visit, MH stage, vitreomacular traction (VMT), presence of SRF, and time to SRF resolution were recorded. Correlation between presenting clinical factors and post-operative SRF were evaluated by the chi-squared test, and difference in BCVA was calculated using the two-sample t-test. Results : 40 eyes of 40 patients were studied (67.5% female, 32.5% male) for a mean of 8.9 months with a mean age of presentation of 67.4?±5.6 years. 57% of the eyes were low stage (I and II) MH and 55% of the MHs were associated with VMT. MH closure was observed in all operated eyes. SRF was found in 29/40 eyes examined. Absorption of SRF was observed in 58.6% of affected eyes with a mean time to absorption of 3.8 months (range 2-6 months). Eyes with SRF gained a mean of 0.08 logMAR units of vision after resolution. Final BCVA was similar between the eyes that did and that did not develop SRF (0.369 vs 0.459, p 0.05). 93% of eyes with stage II MH developed SRF compared to 53% of Stage III and 67% of Stage IV MH. 95% of eyes with VMT at presentation developed SRF compared to 55% of eyes without. Lower staeg MH and presence of VMT was found to be significantly associated with SRF (p= 0.023, and p= 0.014, respectively). Conclusions : SRF post-MHR occurred in 58.6% of cases reviewed, resorbed within 6 months, did not affect final BCVA, and was associated with lower stage MH and VMT. It can be hypothesized that rapid closure of lower stage macular holes trap SRF upon resolution. The gain of small amounts of vision upon the resolution of the fluid suggests that impact of the fluid may be temporary. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.