Effect of perioperative multidisciplinary collaborative nursing combined with preoperative and postoperative OCT assessment on outcomes in patients with idiopathic macular hole

Objective This study intended to explore the clinical efficacy of multidisciplinary collaborative perioperative nursing with optical coherence tomography (OCT)-guided assessment in the rehabilitation prognosis of patients with idiopathic macular holes (IMH). Methods A total of 152 subjects with idiopathic macular hole were recruited, and they were randomly assigned into a routine nursing (RN) group and a multidisciplinary collaborative perioperative nursing with OCT-guided assessment group (MCN group, routine nursing combined with multidisciplinary collaborative perioperative nursing with OCT-guided assessment). All the subjects underwent standard vitreous surgery, together with an inverted internal limiting membrane (ILM) flap coverage procedure. The best corrected visual acuity and intraocular pressure between the two groups were comparatively analyzed before surgery and 6 months postoperatively. OCT imaging was used to assess changes in macular retinal thickness (MRT), macular hole index (MHI), diameter hole index (DHI) and tractional hole index (THI). The emotional status of enrolled patients was further evaluated using anxiety and depression self-rating scales. The compliance rate with postoperative special positioning and the occurrence of complications were recorded. Results At 6 months postoperatively, both groups achieved significant postoperative visual improvement, with superior visual outcomes observed in the MCN group compared with the RN group ( P < 0.05). No significant between-group difference was detected in intraocular pressure ( P > 0.05). At 6 months postoperative follow-up, MHI, DHI, and MRT values were decreased and THI was increased in both groups when compared with baseline data ( P < 0.05). Nevertheless, when compared with RN group, the MCN group had lower MHI, DHI and MRT as well as higher THI ( P < 0.05). Moreover, the MCN group obtained lower scores on anxiety and depression assessment scales, achieved higher adherence to postoperative specified body position requirements ( P < 0.05). Although the overall complication rate in the MCN group was lower than that in the RN group (3.95% vs 9.21%), the difference was not statistically significant (Fisher's exact test, P = 0.200). Conclusion OCT image-based multidisciplinary collaborative care contributes to improved postoperative visual function, macular structural recovery, negative emotions, and positioning adherence in patients with IMH, without increasing the risk of complications, and thus has important clinical application value.