Long-term functional outcome of macular hole surgery correlated to optical coherence tomography measurements.
OBJECTIVE
Evaluation of long-term functional outcome after macular hole surgery and its correlation with postoperative optical coherence tomography (OCT).


METHODS
Before and after surgery a complete clinical examination and OCT were performed in 38 patients. Best corrected postoperative visual acuity (VA) was correlated to the following OCT parameters: preoperative base and minimum diameter of the hole, hole height, hole form factor, retinal thickness and nerve-fibre layer measurements postoperatively, postoperative foveal contour, appearance of retinal pigment epithelium layer and photoreceptor layer.


RESULTS
Over a mean follow up of 67 months, VA improved significantly (P=0.01). Retinal thickness and retinal thickness and nerve-fibre layer measurements of the operated eye did not differ from fellow eye. A negative correlation was seen between final VA and preoperative base diameter of the hole (r=-0.41, P=0.02) and hole height (r=-0.45, P=0.01). The correlation between hole form factor values and final VA (r=0.36, P=0.04) was weak. Appearance of the photoreceptor band was the only OCT parameter significantly correlating with final VA (r=-0.42, P=0.01) and explaining the observed increase (r=-0.32, P=0.05) in VA.


CONCLUSIONS
Appearance of the photoreceptor layer on postoperative OCT correlates to functional outcome and may help to explain cases of unsatisfactory postoperative VA despite successful hole closure.
Haritoglou
Christos
C
Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany. christos.haritoglou@med.uni-muenchen.de
Neubauer
Aljoscha S
AS
Reiniger
Ingrid W
IW
Priglinger
Siegfried G
SG
Gass
Carolin A
CA
Kampik
Anselm
A
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D011184:Postoperative Period; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*