Optical cross-sectional evaluation of successfully repaired idiopathic macular holes by retinal thickness analyzer.
OBJECTIVE
To describe optical cross-sectional images of successfully repaired idiopathic macular holes and to determine the influences of epiretinal membranes and retinal pigment epithelial (RPE) changes on foveal reconstruction and the correlation between retinal thickness and postoperative visual acuity.


METHODS
In a prospective study, optical cross-sectional imaging and retinal thickness measurement of the macula using a retinal thickness analyzer were performed on 63 eyes of 63 patients who underwent successful macular hole surgery.


RESULTS
Cross-sectional images of foveal reconstruction were morphologically categorized into four patterns: normal fovea (23 eyes [37%]), cavernous fovea (19 eyes [30%]), flat fovea (11 eyes [17%]), and irregular fovea (10 eyes [16%]). Epiretinal membranes were observed in the last two groups (55% and 40%) and RPE changes were observed only in the irregular fovea group (16%). The mean retinal thickness of the fovea in all eyes was 213 +/- 92 microm (mean +/- SD; range, 93-570 microm), which varied significantly (P < 0.001) among the four groups. Linear regression analysis showed a significant correlation between retinal thickness at the fovea and logarithmic converted visual acuity (R2 = 0.42, P < 0.001).


CONCLUSIONS
Structural features of foveal reconstruction following successful macular hole surgery involved four patters: normal fovea, cavernous fovea, flat fovea, and irregular fovea. Retinal thickness of the fovea, which varied among the groups, correlated with postoperative visual acuity. Postoperative epiretinal membrane formation and RPE damage may disturb normal foveal reconstruction and visual recovery.
Yamanishi
S
S
Department of Ophthalmology, Osaka Rosai Hospital, Japan. shige@m.ehime-u.ac.jp
Oshima
Y
Y
Emi
K
K
Motokura
M
M
D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D019773:Epiretinal Membrane / Q000473:pathology; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology; D011184:Postoperative Period; D011446:Prospective Studies; D012167:Retinal Perforations / Q000473:pathology* / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy