The effect of ethnicity on anatomic success following macular hole surgery: a multicentre cohort study

Purpose The purpose is to assess the effect of ethnicity on surgical macular hole closure. Methods A retrospective cohort study was undertaken in five UK National Health Service Hospitals. We included all patients with known ethnicity undergoing vitrectomy, internal limiting membrane peel, and gas/o...

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Veröffentlicht in:Graefe's archive for clinical and experimental ophthalmology 2023-06, Vol.261 (6), p.1535-1543
Hauptverfasser: Laviers, Heidi, Papavasileiou, Evangelia, Bruce, Charlotte, Maubon, Laura, Radia, Meera, Dervenis, Nikolaos, Zuckerman, Benjamin, Loh, Graeme K., Theodorou, Olga, Douiri, Abdel, Zambarakji, Hadi, Sandinha, Teresa, Steel, David H., Kirthi, Varo, McKechnie, Cordelia, Zakir, Rahila, Duguid, Graham, Jackson, Timothy L.
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container_issue 6
container_start_page 1535
container_title Graefe's archive for clinical and experimental ophthalmology
container_volume 261
creator Laviers, Heidi
Papavasileiou, Evangelia
Bruce, Charlotte
Maubon, Laura
Radia, Meera
Dervenis, Nikolaos
Zuckerman, Benjamin
Loh, Graeme K.
Theodorou, Olga
Douiri, Abdel
Zambarakji, Hadi
Sandinha, Teresa
Steel, David H.
Kirthi, Varo
McKechnie, Cordelia
Zakir, Rahila
Duguid, Graham
Jackson, Timothy L.
description Purpose The purpose is to assess the effect of ethnicity on surgical macular hole closure. Methods A retrospective cohort study was undertaken in five UK National Health Service Hospitals. We included all patients with known ethnicity undergoing vitrectomy, internal limiting membrane peel, and gas/oil tamponade for all stages of primary full-thickness macular hole (FTMH). The primary outcome was anatomic success, defined as FTMH closure with one operation. The secondary outcome was mean change in best-corrected visual acuity (BCVA) comparing baseline with final review. Results Of 334 operations, the ethnicity profile comprised 78.7% White patients, 11.7% Black patients, 8.1% Asian patients, and 1.5% in mixed/other ethnicities. Mean age was 69.7 years with 68.5% females. Overall, 280 (83.8%) had anatomic success. Anatomic failure occurred in 38.5% of Black patients versus 12.6% of White patients (relative risk: 1.788; 95% CI: 1.012 to 3.159; P  = 0.045). Overall, baseline logarithm of the minimum angle of resolution BCVA improved by 0.34, from 0.95 (95% CI: 0.894 to 1.008) to 0.62 (95% CI: 0.556 to 0.676). Mean BCVA improved by 0.35 in White patients, 0.37 in Black patients, 0.23 in Asian patients, and 0.38 in mixed/other ethnicity ( P  = 0.689). Greater FTMH minimum linear diameter was associated with an increased risk of anatomic failure (relative risk: 1.004; 95% CI: 1.002 to 1.005; P  
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Methods A retrospective cohort study was undertaken in five UK National Health Service Hospitals. We included all patients with known ethnicity undergoing vitrectomy, internal limiting membrane peel, and gas/oil tamponade for all stages of primary full-thickness macular hole (FTMH). The primary outcome was anatomic success, defined as FTMH closure with one operation. The secondary outcome was mean change in best-corrected visual acuity (BCVA) comparing baseline with final review. Results Of 334 operations, the ethnicity profile comprised 78.7% White patients, 11.7% Black patients, 8.1% Asian patients, and 1.5% in mixed/other ethnicities. Mean age was 69.7 years with 68.5% females. Overall, 280 (83.8%) had anatomic success. Anatomic failure occurred in 38.5% of Black patients versus 12.6% of White patients (relative risk: 1.788; 95% CI: 1.012 to 3.159; P  = 0.045). Overall, baseline logarithm of the minimum angle of resolution BCVA improved by 0.34, from 0.95 (95% CI: 0.894 to 1.008) to 0.62 (95% CI: 0.556 to 0.676). Mean BCVA improved by 0.35 in White patients, 0.37 in Black patients, 0.23 in Asian patients, and 0.38 in mixed/other ethnicity ( P  = 0.689). Greater FTMH minimum linear diameter was associated with an increased risk of anatomic failure (relative risk: 1.004; 95% CI: 1.002 to 1.005; P  &lt; 0.0001), whereas better pre-operative BCVA ( F [1,19] = 162.90; P  &lt; 0.0001) and anatomic success ( F [1,19] = 97.69; P  &lt; 0.0001) were associated with greater BCVA improvement. Socio-economic status did not significantly influence anatomic success or BCVA change. Conclusions Black ethnicity is associated with an approximately twofold greater risk of failed FTMH surgery. The reasons for this difference warrant further study.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-022-05950-w</identifier><identifier>PMID: 36602644</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acuity ; Aged ; Cohort analysis ; Ethnicity ; Female ; Humans ; Macular Holes ; Male ; Medicine ; Medicine &amp; Public Health ; Minority &amp; ethnic groups ; Ophthalmology ; Patients ; Retinal Disorders ; Retinal Perforations - etiology ; Retinal Perforations - surgery ; Retrospective Studies ; State Medicine ; Success ; Surgery ; Tamponade ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy - adverse effects</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2023-06, Vol.261 (6), p.1535-1543</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-b24d8e1faf96041dc935ee018c7b5ae5e02593f2b0e1ff698a66dc53e7bf506b3</citedby><cites>FETCH-LOGICAL-c375t-b24d8e1faf96041dc935ee018c7b5ae5e02593f2b0e1ff698a66dc53e7bf506b3</cites><orcidid>0000-0001-8864-5484</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00417-022-05950-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00417-022-05950-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36602644$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Laviers, Heidi</creatorcontrib><creatorcontrib>Papavasileiou, Evangelia</creatorcontrib><creatorcontrib>Bruce, Charlotte</creatorcontrib><creatorcontrib>Maubon, Laura</creatorcontrib><creatorcontrib>Radia, Meera</creatorcontrib><creatorcontrib>Dervenis, Nikolaos</creatorcontrib><creatorcontrib>Zuckerman, Benjamin</creatorcontrib><creatorcontrib>Loh, Graeme K.</creatorcontrib><creatorcontrib>Theodorou, Olga</creatorcontrib><creatorcontrib>Douiri, Abdel</creatorcontrib><creatorcontrib>Zambarakji, Hadi</creatorcontrib><creatorcontrib>Sandinha, Teresa</creatorcontrib><creatorcontrib>Steel, David H.</creatorcontrib><creatorcontrib>Kirthi, Varo</creatorcontrib><creatorcontrib>McKechnie, Cordelia</creatorcontrib><creatorcontrib>Zakir, Rahila</creatorcontrib><creatorcontrib>Duguid, Graham</creatorcontrib><creatorcontrib>Jackson, Timothy L.</creatorcontrib><title>The effect of ethnicity on anatomic success following macular hole surgery: a multicentre cohort study</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>Purpose The purpose is to assess the effect of ethnicity on surgical macular hole closure. Methods A retrospective cohort study was undertaken in five UK National Health Service Hospitals. We included all patients with known ethnicity undergoing vitrectomy, internal limiting membrane peel, and gas/oil tamponade for all stages of primary full-thickness macular hole (FTMH). The primary outcome was anatomic success, defined as FTMH closure with one operation. The secondary outcome was mean change in best-corrected visual acuity (BCVA) comparing baseline with final review. Results Of 334 operations, the ethnicity profile comprised 78.7% White patients, 11.7% Black patients, 8.1% Asian patients, and 1.5% in mixed/other ethnicities. Mean age was 69.7 years with 68.5% females. Overall, 280 (83.8%) had anatomic success. Anatomic failure occurred in 38.5% of Black patients versus 12.6% of White patients (relative risk: 1.788; 95% CI: 1.012 to 3.159; P  = 0.045). Overall, baseline logarithm of the minimum angle of resolution BCVA improved by 0.34, from 0.95 (95% CI: 0.894 to 1.008) to 0.62 (95% CI: 0.556 to 0.676). Mean BCVA improved by 0.35 in White patients, 0.37 in Black patients, 0.23 in Asian patients, and 0.38 in mixed/other ethnicity ( P  = 0.689). Greater FTMH minimum linear diameter was associated with an increased risk of anatomic failure (relative risk: 1.004; 95% CI: 1.002 to 1.005; P  &lt; 0.0001), whereas better pre-operative BCVA ( F [1,19] = 162.90; P  &lt; 0.0001) and anatomic success ( F [1,19] = 97.69; P  &lt; 0.0001) were associated with greater BCVA improvement. Socio-economic status did not significantly influence anatomic success or BCVA change. Conclusions Black ethnicity is associated with an approximately twofold greater risk of failed FTMH surgery. The reasons for this difference warrant further study.</description><subject>Acuity</subject><subject>Aged</subject><subject>Cohort analysis</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Humans</subject><subject>Macular Holes</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Minority &amp; ethnic groups</subject><subject>Ophthalmology</subject><subject>Patients</subject><subject>Retinal Disorders</subject><subject>Retinal Perforations - etiology</subject><subject>Retinal Perforations - surgery</subject><subject>Retrospective Studies</subject><subject>State Medicine</subject><subject>Success</subject><subject>Surgery</subject><subject>Tamponade</subject><subject>Tomography, Optical Coherence</subject><subject>Visual Acuity</subject><subject>Vitrectomy - adverse effects</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kMtKBDEQRYMoOj5-wIUEXLdWkk4_3In4AsHNCO5COl2Z6aG7o0maYf7e6PjYuapFnXuLOoScMrhgAOVlAMhZmQHnGchaQrbeITOWC5mVwF93yQxKzrJK8NcDchjCChIvJNsnB6IogBd5PiN2vkSK1qKJ1FmKcTl2posb6kaqRx3d0BkaJmMwBGpd37t1Ny7ooM3Ua0-Xrse09gv0myuq6TD1sTM4Ro_UuKXzkYY4tZtjsmd1H_Dkex6Rl7vb-c1D9vR8_3hz_ZQZUcqYNTxvK2RW27pIv7WmFhIRWGXKRmqUCFzWwvIGEmSLutJF0RopsGyshKIRR-R82_vm3fuEIaqVm_yYTipeMVnlnNdloviWMt6F4NGqN98N2m8UA_WpVm3VqqRWfalV6xQ6-66emgHb38iPywSILRDSakxG_m7_U_sBR5SGpA</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Laviers, Heidi</creator><creator>Papavasileiou, Evangelia</creator><creator>Bruce, Charlotte</creator><creator>Maubon, Laura</creator><creator>Radia, Meera</creator><creator>Dervenis, Nikolaos</creator><creator>Zuckerman, Benjamin</creator><creator>Loh, Graeme K.</creator><creator>Theodorou, Olga</creator><creator>Douiri, Abdel</creator><creator>Zambarakji, Hadi</creator><creator>Sandinha, Teresa</creator><creator>Steel, David H.</creator><creator>Kirthi, Varo</creator><creator>McKechnie, Cordelia</creator><creator>Zakir, Rahila</creator><creator>Duguid, Graham</creator><creator>Jackson, Timothy L.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><orcidid>https://orcid.org/0000-0001-8864-5484</orcidid></search><sort><creationdate>20230601</creationdate><title>The effect of ethnicity on anatomic success following macular hole surgery: a multicentre cohort study</title><author>Laviers, Heidi ; Papavasileiou, Evangelia ; Bruce, Charlotte ; Maubon, Laura ; Radia, Meera ; Dervenis, Nikolaos ; Zuckerman, Benjamin ; Loh, Graeme K. ; Theodorou, Olga ; Douiri, Abdel ; Zambarakji, Hadi ; Sandinha, Teresa ; Steel, David H. ; Kirthi, Varo ; McKechnie, Cordelia ; Zakir, Rahila ; Duguid, Graham ; Jackson, Timothy L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-b24d8e1faf96041dc935ee018c7b5ae5e02593f2b0e1ff698a66dc53e7bf506b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acuity</topic><topic>Aged</topic><topic>Cohort analysis</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Humans</topic><topic>Macular Holes</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Minority &amp; ethnic groups</topic><topic>Ophthalmology</topic><topic>Patients</topic><topic>Retinal Disorders</topic><topic>Retinal Perforations - etiology</topic><topic>Retinal Perforations - surgery</topic><topic>Retrospective Studies</topic><topic>State Medicine</topic><topic>Success</topic><topic>Surgery</topic><topic>Tamponade</topic><topic>Tomography, Optical Coherence</topic><topic>Visual Acuity</topic><topic>Vitrectomy - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laviers, Heidi</creatorcontrib><creatorcontrib>Papavasileiou, Evangelia</creatorcontrib><creatorcontrib>Bruce, Charlotte</creatorcontrib><creatorcontrib>Maubon, Laura</creatorcontrib><creatorcontrib>Radia, Meera</creatorcontrib><creatorcontrib>Dervenis, Nikolaos</creatorcontrib><creatorcontrib>Zuckerman, Benjamin</creatorcontrib><creatorcontrib>Loh, Graeme K.</creatorcontrib><creatorcontrib>Theodorou, Olga</creatorcontrib><creatorcontrib>Douiri, Abdel</creatorcontrib><creatorcontrib>Zambarakji, Hadi</creatorcontrib><creatorcontrib>Sandinha, Teresa</creatorcontrib><creatorcontrib>Steel, David H.</creatorcontrib><creatorcontrib>Kirthi, Varo</creatorcontrib><creatorcontrib>McKechnie, Cordelia</creatorcontrib><creatorcontrib>Zakir, Rahila</creatorcontrib><creatorcontrib>Duguid, Graham</creatorcontrib><creatorcontrib>Jackson, Timothy L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health &amp; 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Methods A retrospective cohort study was undertaken in five UK National Health Service Hospitals. We included all patients with known ethnicity undergoing vitrectomy, internal limiting membrane peel, and gas/oil tamponade for all stages of primary full-thickness macular hole (FTMH). The primary outcome was anatomic success, defined as FTMH closure with one operation. The secondary outcome was mean change in best-corrected visual acuity (BCVA) comparing baseline with final review. Results Of 334 operations, the ethnicity profile comprised 78.7% White patients, 11.7% Black patients, 8.1% Asian patients, and 1.5% in mixed/other ethnicities. Mean age was 69.7 years with 68.5% females. Overall, 280 (83.8%) had anatomic success. Anatomic failure occurred in 38.5% of Black patients versus 12.6% of White patients (relative risk: 1.788; 95% CI: 1.012 to 3.159; P  = 0.045). Overall, baseline logarithm of the minimum angle of resolution BCVA improved by 0.34, from 0.95 (95% CI: 0.894 to 1.008) to 0.62 (95% CI: 0.556 to 0.676). Mean BCVA improved by 0.35 in White patients, 0.37 in Black patients, 0.23 in Asian patients, and 0.38 in mixed/other ethnicity ( P  = 0.689). Greater FTMH minimum linear diameter was associated with an increased risk of anatomic failure (relative risk: 1.004; 95% CI: 1.002 to 1.005; P  &lt; 0.0001), whereas better pre-operative BCVA ( F [1,19] = 162.90; P  &lt; 0.0001) and anatomic success ( F [1,19] = 97.69; P  &lt; 0.0001) were associated with greater BCVA improvement. Socio-economic status did not significantly influence anatomic success or BCVA change. Conclusions Black ethnicity is associated with an approximately twofold greater risk of failed FTMH surgery. The reasons for this difference warrant further study.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36602644</pmid><doi>10.1007/s00417-022-05950-w</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8864-5484</orcidid></addata></record>
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language eng
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subjects Acuity
Aged
Cohort analysis
Ethnicity
Female
Humans
Macular Holes
Male
Medicine
Medicine & Public Health
Minority & ethnic groups
Ophthalmology
Patients
Retinal Disorders
Retinal Perforations - etiology
Retinal Perforations - surgery
Retrospective Studies
State Medicine
Success
Surgery
Tamponade
Tomography, Optical Coherence
Visual Acuity
Vitrectomy - adverse effects
title The effect of ethnicity on anatomic success following macular hole surgery: a multicentre cohort study
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