Pre- and post-operative differences between genders in idiopathic macular holes
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RESEARCH ARTICLE
Open Access
Pre- and post-operative differences between genders in idiopathic macular holes Jing Wang†, Yanping Yu†, Xida Liang, Zengyi Wang, Biying Qi and Wu Liu*
Abstract Background: To compare idiopathic macular holes (IMHs) between male and female before and after surgery. Methods: Patients with IMHs of stage 3 and stage 4 who underwent 23-gauge vitrectomy were retrospectively enrolled. Pre-operative clinical features like age of onset, and best-corrected visual acuity (BCVA) were reviewed. Optical coherence tomography parameters including minimum linear diameter (MLD), central macular thickness and some other indexes were measured and calculated. Main surgical outcomes included the primary closure rate, the highest BCVA during follow-up, and the recovery duration. All the metrics mentioned above were compared between genders with appropriate statistical methods. Results: A total of 298 eyes from 280 patients (male: 51; female: 229) were enrolled. Compared with men, women demonstrated a significantly higher ratio of stage3/stage4 (P = 0.045), larger horizontal MLD (P = 0.009), but similar surgical outcomes except for a relatively longer recovery duration (P = 0.024). For stage 3 IMHs, women exhibited significantly younger age of onset (P = 0.023), larger MLD (P = 0.003), and smaller height of the hole (P = 0.029). However, for stage 4 IMHs, all the pre- and post-operative metrics showed no differences between genders. Conclusions: Female IMHs seem to demonstrate an earlier age of onset and larger size of hole, especially in IMHs of stage 3. However, these differences, which may owe to normal gender-related variations, have limited influence on the surgical outcomes. Keywords: Gender variation, Idiopathic macular hole, Optical coherence tomography, Vitrectomy
Background Idiopathic macular holes (IMHs) are full-thickness defect in the neuroretina with unknown specific causes [1], which greatly reduce vision health-related quality of life [2]. The incidence of IMH is approximately 0.01 to 0.09% [3], with a female to male ratio of about 3:1 [3]. Although the pathogenesis of IMH is not completely clear, vitreomacular traction has been considered as one of the most important motivating factors [4]. * Correspondence: [email protected] † Jing Wang and Yanping Yu contributed equally to this work. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology and Visual Sciences Key Laboratory, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
Clinically, gender variation is not rare in fundus diseases. Several studies considered male gender as a risk factor for central serous chorioretinopathy (CSC) [5], and female subjects with CSC tend to obtain better prognosis [6]. Another report showed that women had a potentially higher risk of neovascular age-related macular degeneration compared to men [7]. Besides different incidences, male and female IMHs may exhibit different manifestations and surgical outcomes since women demonstrate wider
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