Page 41 - A Magyar Szemorvostársaság 2022. évi kongresszusának programja és az előadások kivonata

Elődáskivonatok/Abstracts

Prediction of postoperative visual acuity using optical coherence
tomography (OCT) parameters in macular hole surgeries
Beáta Bajdik, Lili Takács, Attila Vajas, Gréta Kemenes, Eszter Szász, Mariann Fodor
Department of Ophthalmology University of Debrecen

Background: With today's surgical techniques, 90% of macular holes (MH) may be closed, but the degree of vision improvement varies
and depends on the photoreceptor loss during MH formation. The extent of the latter can be estimated based on the morphological features of
MH according to recent literature data. Several indicators have been described for estimating postoperative visual acuity, of which the most
used is the macular hole index (MHI) and the most accurate is a complex indicator based on the measurement of the outer limiting memb-
rane (ELM). Our goal is to determine simple preoperative OCT parameters based on newer theories of MH formation that may help predict
post-surgery visual acuity and receptor deficiency in closed MH.
Methods: In a retrospective study, data were collected from patients treated for MH at our department by 2 operators. Only those cases were
considered, where MH was closed, postoperative results of at least 6 months were available, OCT images of adequate quality were taken,
and the patient was pseudophakic at the time of the last visual acuity examination. Data from a total of 28 patients were processed. On the
preoperative OCT images, the displacement and deficiency in the retinal layers were measured, the MHI was calculated, a simplified ELM
index (eELMi) was introduced, and the B/A index (distance between the inner layers/base of the hole) was determined based on the closure
theories. The correlation between these parameters and the last visual acuity after surgery was analised.
Results: MHI showed a similar correlation with postoperative visual acuity as in the literature (r = 0.659, p<0.001), with a similar
correlation with B/A index (r=0.625, p<0.001). eELMI correlated well with the absence of postoperative ellipsoid zone (EZ) reflecting
photoreceptor damage (r=-0.620, p=0.004), the latter correlated well with postoperative visual acuity (r=–0.639, p<0.001). However, the
correlation between eELMi and visual acuity (r=-0.134) was not significant (p=0.496), presumably due to the low number of cases and
the retrospective study methodology.
Conclusion: eELMi can help predict morphological characteristics that determine postoperative visual acuity, while the B/A index can help
predict postoperative visual acuity. Our data support recent theories about the formation of MH.

Membrana limitans interna peeling után kialakuló teljes vastagságú
maculalyuk lehetséges műtéti megoldása
Rozmán Beáta, Zelkó András, Bátor György
Markusovszky Egyetemi Oktatókórház Szemészeti Osztály

Célkitűzés: Lamellaris maculalyuk miatt végzett pars plana vitrectomia, ERM és ILM peeling után kialakuló teljes vastagságú
maculalyuk ILM lebennyel történő megoldásának bemutatása.
Módszer: 68 éves férfi betegünk esetének ismertetése, akinél epiretinalis membran, lamellalis maculalyuk miatt ILM peelin-
get végeztünk. A műtétet követően teljes vastagságú maculaforamen alakult ki, mely miatt ismételt pars plana vitrectomia
történt, ILM lebeny áthelyezéssel, gáz tamponáddal.
Eredmény: A 2. műtét után a maculalyuk záródott, a beteg látóélessége javult, metamorphopsiája csökkent.
Következtetés: ERM peelinget követően kialakuló maculalyuk ritka, de lehetséges következmény. Bizonyos esetekben ILM
lebeny készítése, gáz tamponád behelyezése megoldást jelenthet.
A potential solution of Internal limiting membrane peeling followed
by full thickness macular hole
Beáta Rozmán, András Zelkó, György Bátor
Markusovszky University Teaching Hospital, Szombathely

Purpose: To present a surgical solution of a full thickness macular hole which developed after pars plana vitrectomy, epiretinal membrane
and internal limiting membrane peeling because of lamellar macular hole and ERM.
Method: To present a case of a 68 yrs male patient with lamellar macular hole and epiretinal membrane, who underwent pars plana
vitrectomy, ERM and ILM peeling. A full thickness macular hole developed after the operation, therefore a 2 pars plana vitrectomy was
nd
performed with internal limiting membrane transposition and gas tamponade.
Result: After the 2 operation the closure of the macular hole was present, BCVA improved and metamorphopsy decreased.
nd
Conclusion: Full thicknes macular hole after ILM peeling is a rare but potentinial complication. In certain cases ILM transposition, gas
tamponade can resolve the pathology.

38