Correlation between foveal structure and visual outcome following macular hole surgery: a spectral optical coherence tomography study.
OBJECTIVE
The aim of this paper is to evaluate the retinal structure after macular hole surgery and to study the correlation of structural findings with final functional outcomes, using high-speed, high-resolution spectral optical coherence tomography (SOCT).


METHODS
Sixty-eight eyes of 60 patients with full-thickness macular holes were included in the study. All patients underwent pars plana vitrectomy with trypan blue staining and internal limiting membrane (ILM) peeling. Patients were evaluated by SOCT, with 6 mum axial and 12-18 mum transverse resolution and three-dimensional images of the retina.


RESULTS
There were four different types of macular hole closure: U-shape, V-shape, irregular and flat/open. The following retinal abnormalities were observed in postoperative scans: photoreceptor irregularities, lack of photoreceptors (photoreceptor defect), cysts in outer retinal layers, nerve fiber layer defects, lesion of all retinal layers, and RPE defects. It was possible to evaluate photoreceptor defects on a three-dimensional image. Retinal thickness in the fovea was also measured.


CONCLUSIONS
Because of excellent resolution, SOCT is capable of visualization of retinal defects after macular hole surgery. Three-dimensional examination is adequate for evaluation of photoreceptor defects. Good postoperative visual acuity is correlated with U-shape closure, normal foveal thickness and absence of photoreceptor layer defects.
Michalewska
Zofia
Z
Klinika Okulistyczna Jasne Blonia, ul. Rojna 90, Lodz 91-162, Poland. zosia_n@yahoo.com
Michalewski
Janusz
J
Cisiecki
Slawomir
S
Adelman
Ron
R
Nawrocki
Jerzy
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000503:physiopathology* / Q000601:surgery*; D013194:Staining and Labeling; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014343:Trypan Blue; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
D014343:Trypan Blue