Primary vitrectomy for degenerative and tractional lamellar macular holes: A systematic review and meta-analysis.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
28
10
2020
accepted:
24
01
2021
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
27
8
2021
Statut:
epublish
Résumé
To assess the efficacy of vitrectomy in degenerative and tractional lamellar macular holes (LMHs) by meta-analysis of published studies. PubMed, Medline and Embase databases were searched up to May 2020. Included cohorts were divided into three groups: degenerative LMH group, lamellar hole associated epiretinal proliferation (LHEP) group and tractional LMH group. LHEP is likely to be associated with degenerative LMHs, but less commonly could be associated with mixed LMHs. To reduce risk of possible misclassification bias, eyes with LHEP which could not have been precisely classified by the authors, were included into the LHEP group. The primary outcome was to investigate the visual change following primary vitrectomy in the degenerative LMH and LHEP group versus the tractional LMH group. A sensitivity analysis excluding the LHEP group was also performed on the primary outcome. Mean difference (MD) in best corrected visual acuity between baseline and post-treatment was calculated, along with 95% confidence interval (CI). Rate of incidence of post-operative full-thickness macular hole (FTMH) was assessed as secondary outcome. Thirteen studies were included. Pooled analyses including all groups showed a significant visual improvement following vitrectomy (pre-post MD = -0.17;95%CI = -0.22,-0.12;p<0.001), with no difference in visual improvement between the degenerative LMH and LHEP group and the tractional LMH group. The sensitivity analysis excluding LHEP group confirmed no difference in visual change between the degenerative LMH group (pre-post MD = -0.18;95%CI = -0.24,-0.12;p<0.001) and the tractional LMH group (MD = -0.16;95%CI = -0.26,-0.07;p<0.001). The incidence rate of post-operative FTMH was higher in the degenerative LMH and LHEP group than in the tractional LMH group (p = 0.002). Primary vitrectomy for LMH ensured a favorable visual outcome, with no difference in visual gain between degenerative and tractional LMHs. However, a higher incidence of post-operative FTMHs was found in eyes with the degenerative LMH subtype.
Identifiants
pubmed: 33667237
doi: 10.1371/journal.pone.0246667
pii: PONE-D-20-33943
pmc: PMC7935291
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0246667Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Eye (Lond). 2020 Apr;34(4):683-689
pubmed: 31527762
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
Ophthalmology. 2008 May;115(5):884-886.e1
pubmed: 18067968
Graefes Arch Clin Exp Ophthalmol. 2016 Apr;254(4):629-38
pubmed: 26311257
Ophthalmologica. 2019;242(1):49-58
pubmed: 30739110
Invest Ophthalmol Vis Sci. 2011 Nov 25;52(12):9074-83
pubmed: 22025575
Acta Ophthalmol. 2020 Aug 24;:
pubmed: 32833307
Arch Neurol. 2003 Apr;60(4):529-33
pubmed: 12707066
Br J Ophthalmol. 2018 Jan;102(1):84-90
pubmed: 28546149
JAMA Ophthalmol. 2019 Nov 21;:
pubmed: 31750861
Graefes Arch Clin Exp Ophthalmol. 2013 Feb;251(2):467-75
pubmed: 22569859
Sci Rep. 2019 Nov 5;9(1):16030
pubmed: 31690760
Ophthalmic Surg Lasers Imaging. 2010 Jul-Aug;41(4):418-24
pubmed: 20438044
Acta Ophthalmol. 2017 May;95(3):e221-e226
pubmed: 27647708
Eur J Epidemiol. 2010 Sep;25(9):603-5
pubmed: 20652370
Br J Ophthalmol. 2020 Dec;104(12):1741-1747
pubmed: 32107208
Retina. 2019 Nov;39(11):2090-2098
pubmed: 30312255
Retina. 2012 Oct;32(9):1743-8
pubmed: 22596099
Retina. 2018 Apr;38(4):664-669
pubmed: 28301339
J Fr Ophtalmol. 1998 Aug-Sep;21(7):484-94
pubmed: 9805683
Arch Public Health. 2014 Nov 10;72(1):39
pubmed: 25810908
Graefes Arch Clin Exp Ophthalmol. 2018 Jul;256(7):1265-1273
pubmed: 29785511
J Ophthalmol. 2015;2015:450212
pubmed: 26425350
Am J Ophthalmol. 2017 Mar;175:16-29
pubmed: 27889502
Retina. 2018 Jul;38(7):1316-1323
pubmed: 28538264
Ophthalmology. 2006 Mar;113(3):388-97
pubmed: 16513456
Retina. 2020 Jun;40(6):1087-1093
pubmed: 31107710
Clin Ophthalmol. 2019 Dec 19;13:2541-2546
pubmed: 31908409
PLoS One. 2018 Jul 19;13(7):e0201010
pubmed: 30024983
Graefes Arch Clin Exp Ophthalmol. 2019 Oct;257(10):2147-2154
pubmed: 31342148
Am J Ophthalmol. 2016 Apr;164:99-109
pubmed: 26898164
Ophthalmology. 2004 Feb;111(2):238-43
pubmed: 15019369
Ophthalmic Res. 2019;61(2):73-82
pubmed: 30625477
Am J Ophthalmol. 2016 Jan;161:78-93.e1-2
pubmed: 26432929