Older patients less responsive to macular hole surgery

Issue: March 25, 2017

Older patients experienced less improvement in visual acuity and recovery of retinal microstructures following macular hole surgery, according to a study.

The retrospective study analyzed the relation between age and restoration of visual and functional outcomes in 83 eyes of 83 patients with closed idiopathic macular holes after the surgery.

The patients were divided into four age groups, with 20 patients in the age 60 and younger group, 22 patients in the 61 to 65 age group, 19 patients in the 66 to 70 age group, and 22 patients in the older than 70 age group.

At 12 months following surgery, patients in the two younger groups each experienced a mean visual improvement of 0.4 logMAR. Mean improvement in the 66 to 70 age group was 0.2 logMAR and for the oldest group was 0.1 logMAR (P = .001).

Spectral domain optical coherence tomography was used to analyze postoperative reconstruction of retinal microstructures.

A total of 22 eyes in the two older groups (53.7%) showed microstructural recovery in those areas compared with 32 eyes (76.2%) in the two younger groups (P = .018). Time to such restoration likewise lagged behind for the groups older than age 65 (10.2 months) compared with the younger two groups (7.1 months, P < .001).

“This age-dependent outcome might be due to alterations in calcium homeostasis, loss of N-cadherin expression and accumulated subretinal macrophages in the outer retina that occur with age,” the study authors wrote. – by Joe Green

Disclosure : The authors report no relevant financial disclosures.

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Source:

Kim Y, et al. Retina 2017;10.1097/IAE.0000000000001162.