title: Foveal microstructure on spectral-domain optical coherence tomographic images and visual function after macular hole surgery.
abstract: OBJECTIVE
  To determine the correlation between the recovery of foveal microstructure and the visual acuity or the foveal sensitivity after idiopathic macular hole (MH) closure.
  
  
  METHODS
  Prospective, consecutive, observational case series.
  
  
  METHODS
  We studied 43 eyes of 43 patients before and 1, 3, and 6 months after MH surgery. The best-corrected visual acuity (BCVA), the foveal sensitivity measured by MP1 microperimetry, and the photoreceptor inner and outer segment (IS/OS) junction and the external limiting membrane (ELM) determined by spectral-domain optical coherence tomography were investigated.
  
  
  RESULTS
  Preoperatively, the lengths of the IS/OS junction defect and the ELM defect were significantly correlated with only the foveal sensitivity (P<.0001). At all postoperative times, the lengths of both the IS/OS and ELM defects were significantly correlated with both the BCVA and the foveal sensitivity (P<.05 for all). The preoperative lengths of both the IS/OS and ELM defects were significantly correlated with the foveal sensitivity at 6 months after surgery (P=.0022, P=.0031, respectively). The IS/OS junction defect was significantly correlated with the ELM defect at all times (P<.0001 for all). No restoration of the IS/OS junction was observed in eyes without the ELM restoration.
  
  
  CONCLUSIONS
  The restoration of the ELM is closely associated with that of the IS/OS junction. The preoperative IS/OS or ELM defect was associated with the postoperative foveal sensitivity. The restoration of not only the IS/OS junction but also the ELM may reflect the morphologic and functional recovery of the foveal photoreceptors in surgically closed MHs.
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ooka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mitamura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Baba
authors.forename: Masayasu
authors.initials: M
authors.lastname: Kitahashi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Oshitari
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology; D011184:Postoperative Period; D016684:Prone Position; D011446:Prospective Studies; D020127:Recovery of Function; D012167:Retinal Perforations / Q000503:physiopathology* / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014821:Vitrectomy
chemical_list: D013459:Sulfur Hexafluoride