title: Does postoperative near visual acuity predict macular hole closure?
abstract: To determine whether prone postoperative near visual acuity following macular hole surgery can be used as a reliable indicator of successful hole closure, data from 21 patients undergoing macular hole surgery were collected. Seventeen of the 18 patients with hole closure and all 3 patients with persistent macular holes had a Rosenbaum acuity better than preoperative visual acuity, yielding 94% sensitivity, 0% specificity, 85% positive predictive value, and 0% negative predictive value. Fourteen of the 18 patients with macular hole closure and all 3 patients with persistent macular holes had a Rosenbaum acuity better than 20/40, yielding 78% sensitivity, 0% specificity, 82% positive predictive value, and 0% negative predictive value. Although postoperative near visual acuity can predict macular hole closure with 94% sensitivity, the test is not clinically useful to predict hole closure because of the high surgical success rate of macular hole surgery. The test could be useful in encouraging patients to maintain head prone positioning and alleviate patient anxiety.
authors.affiliation: Department of Ophthalmology, Henry Ford Hospital, Detroit, Michigan 48202, USA.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Dhalla
authors.forename: Uday R
authors.initials: UR
authors.lastname: Desai
authors.forename: Cristian
authors.initials: C
authors.lastname: Gandolfo
mesh_terms: D000368:Aged; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011184:Postoperative Period; D011237:Predictive Value of Tests; D016684:Prone Position; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012680:Sensitivity and Specificity; D014787:Vision Tests; D014792:Visual Acuity / Q000502:physiology*