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Atypical epiretinal tissue in full-thickness macular holes: pathogenic and prognostic significance
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  • Published on:
    Confounders to be addressed
    • Tatsuhiko Sato, Vitreoretinal surgeon in Japan Hayashi Eye Hospital, Fukuoka, Japan

    I read with great interest the article by Bae and collegues.1 In their retrospective study, the authors concluded that the presence of atypical epiretinal tissue (AET) in a full-thickness macular hole (FTMH) was related to poorer anatomical success and less visual recovery after surgery.
    I agree with the authors on the association of their OCT findings with the visual prognosis. I also agree with them that it is important to identify a good indicator of visual prognosis based on OCT findings. However, there are many confounders to be addressed in this study. For example, preoperative MH size with OCT has been known as a prognostic factor for postoperative visual outcome and anatomical success rate of MH surgery.2,3 A previous study also demonstrated that ERM prevalence increased with severity and size of the FTMH.4 In addition, preoperative visual acuity or preoperative photoreceptor integrity also seems to correlate with visual prognosis.
    Thus, their results should be supported by appropriate statistical analysis, that is, multivariate regression analyses. I hope that the authors will comment on the results of multivariate regression analyses to identify the most significant factor to predict visual prognosis after MH surgery.

    References
    1. Bae K, Lee SM, Kang SW, et al. Atypical epiretinal tissue in full-thickness macular holes: pathogenic and prognostic significance. Br J Ophthalmol. 2018 (in press)
    2. Ullrich S, Haritoglou C, Gass...

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    Conflict of Interest:
    None declared.