European Vitreoretinal Society Macular Hole Study, Prognostic Factors for Anatomical and Functional Success

Background: To identify prognostic preoperative and intraoperative factors for anatomical and visual success of idiopathic macular hole (MH) surgery. Methods: We conducted a non-randomized, collaborative multicenter study using data of 4207 MH surgery from 140 surgeons. Main study outcomes were anatomical closure and best corrected visual acuity (BCVA) improvement postoperative at 6-12 months. Results: Information on anatomical success was available for 4138 eyes of 4207 operations. Anatomical closure of MH was achieved in 85.7% (3546 eyes). Closure was higher in smaller MH (stages 1-2 versus stage 3: OR=0.35; stage 2 versus stage 4: OR=0.16, and in MH with shorter duration before the operation (OR=0.94). Macular Holes were more likely to close when dyes were used to facilitate internal limiting membrane (ILM) peeling (odds ratio=1.73 to 3.58). The most important predictors of postoperative BCVA were the preoperative BCVA (estimate=0.39, p<0.001) and closure of the macular hole (estimate=0.34, p<0.001). We observed Larger improvement in BCVA in combined vitrectomy and phacoemulsification (estimate = 0.10) and post cataract surgery in phakic eyes (estimate=0.05). Retinal tears occurred in 5.1% of eyes, and were less with use of trocars (OR= -1.246) and in combined vitrectomy/ phacoemulsification surgery (OR= -0.688). Conclusion: This international survey confirmed that staining with dyes improves anatomical results but not visual outcomes. After surgery, visual acuity improved during the first year, and final visual acuity was better in both pseudophakic eyes and eyes that underwent cataract surgery during the first year following MH repair.

Interpretative and Compositional Connotations from a Musicological Perspective

Musicology, viewed as a general science regarding all the defining elements of music, can approach compositions using hermeneutical methods, both through a critical view on the interpretation, the stage performance of the creative act, and through the subsequent musicological writings, becoming a “meta-interpretation” that requires a thorough exegesis. The couplet hermeneutics-interpretation together with that of compositional concept versus stage production are the ones underlying our research, while hermeneutics is the very art of performing that penetrates the most cryptic elements present in the musical act, viewed from the perspective of the triad creation-interpretation-reception. In an attempt to emphasize the ways in which the composer suggests to the performer certain indications for stage performance, through writing, agogics, dynamics and special sound effects, we intend to study, from the standpoint of the musicologist, the piece 5 tablouri cu umbre(le) 1 by Constantin Rîpă. Built on a structure of five tableaux, the work comprises fifteen songs on poems by five contemporary Cluj poets and outlines a new concept of musical performance, which aims to experiment in composing music with the idea of the primordial nature of the poetic text, which is associated with elements of motion and gestures of the interpreters and is based on an arbitrary compositional concept, a defining technique that can be found in a great part of the choral creation of this composer.