ObjectiveTo comparatively observe optical coherence tomography (OCT) image features between traumatic macular hole (TMH) and idiopathic macular hole (IMH). MethodsA retrospective clinical study. A total of 174 patients (174 eyes) with macular hole (MH) diagnosed at Shantou International Eye Center from December 2008 to May 2024 were included in the study. Among them, there were 75 patients (75 eyes) with TMH and 99 patients (99 eyes) with IMH, and they were divided into the TMH group and the IMH group accordingly. All the affected eyes underwent best corrected visual acuity (BCVA) and OCT examinations. The BCVA was examined using a standard logarithmic visual acuity chart, and was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The minimum diameter and basal diameter of the MH, as well as the average, nasal, superior, inferior, and temporal center retinal thickness (CRT) around the MH were measured by OCT. The independent-sample t test was used to compare the logMAR BCVA, hole diameter, and CRT at the hole margin between the groups. ResultsThere were significant differences in age (t=?15.857) and gender ratio (χ2=28.154) between the TMH group and the IMH group (P＜0.05), while there was no significant difference in logMAR BCVA (t=1.962, P＞0.05). The minimum diameter of the hole in the TMH group was smaller than that in the IMH group, but the basal diameter was larger, with significant differences (t=?3.322, 2.570; P＜0.05). The thickness of the neuroepithelial layer at the hole margin in the TMH group was thinner than that in the IMH group, with significant differences in the superior (t=?2.747), inferior (t=?2.316), and nasal (t=?2.851) regions (P＜0.05), and no significant difference in the temporal region (t=?1.586, P＞0.05). In the TMH group, the number of eyes with macular cystoid edema (CME), posterior vitreous detachment (PVD), retinal atrophy, subretinal hemorrhage, choroidal laceration, and focal neuroepithelial detachment was 36 (48.00%, 36/75), 4 (5.33%, 4/75), 4 (5.33%, 4/75), 15 (20.00%, 15/75), 8 (10.67%, 8/75), and 19 (25.33%, 19/75) eyes, respectively. In the IMH group, the number of eyes with CME and PVD was 95 (95.96%, 95/99) and 94 (94.95%, 94/99) eyes, respectively. ConclusionCompared with IMH, TMH has a larger basal diameter, a thinner CRT at the hole margin, a lower incidence of CME and PVD, and a higher incidence of subretinal hemorrhage, focal neuroepithelial detachment, choroidal laceration, and retinal atrophy.
ObjectiveTo explore the related risk factors of vitreous macular interface abnormalities (VMIA) in eyes with diabetic macular edema (DME) after receiving anti-vascular endothelial growth factor (VEGF) drug treatment, and to evaluate the influence of VMIA on the best corrected visual acuity (BCVA) and central retinal thickness (CRT) of the affected eyes. MethodsA retrospective cohort study. From January 2021 to January 2023, 285 DME patients (285 eyes) who received anti-VEGF drug treatment at Tianjin Medical University Eye Hospital and had no VMIA at baseline were included in the study. All affected eyes underwent BCVA examination, and CRT was measured by optical coherence tomography. The treatment plan was a monthly stress therapy for the initial three months, followed by treatment as needed. According to whether VMIA was formed 12 months after treatment, the affected eyes were divided into the VMIA formation group and the non-VMIA formation group, that was further subdivided based on the VMIA classification. Logistic regression model was used to analyze the risk factors for VMIA formation and its influence on BCVA and CRT 12 months after treatment. ResultsTwelve months after treatment, among 285 eyes, 111 eyes (38.9%) developed VMIA (VMIA formation group), and 174 eyes (61.1%) did not develop VMIA (non-VMIA formation group). Logistic regression analysis showed that a thinner baseline CRT [odds ratio (OR=0.99, 95% confidence interval (CI) 0.98-0.99, P=0.04] was associated with a higher number of anti-VEGF drug injections (OR=1.12, 95%CI 1.02-1.23, P=0.02) was a risk factor for the formation of VMIA. However, the formation status of VMIA itself was not an influencing factor for BCVA (OR=1.89, 95%CI 0.98-3.67, P=0.06) or CRT (OR=1.34, 95%CI 0.30-0.83, P=0.40) at 12 months after treatment. The intergroup comparison showed that at 12 months after treatment, the improvement degrees of BCVA and CRT in the VMIA formation group were both worse than those in the non-VMIA formation group (t=2.99, 2.07; P＜0.00, 0.05). Furthermore, in the VMIA subtype analysis, the improvement degree of CRT in the affected eyes with epiretinal membrane (ERM) was significantly lower than that in the affected eyes without ERM (t=4.31, P＜0.001). ConclusionsThinner baseline CRT and more injection times are associated with the occurrence of VMIA; compared with the eyes without VMIA formation, the improvement of BCVA and CRT in the eyes with VMIA formation is less during the 12-month follow-up period after treatment. The formation of VMIA has no significant effect on BCVA or CRT at 12 months after treatment. The improvement effect of CRT is the poorest in patients with ERM.