title: Visual Prognosis of Eyes Recovering From Macular Hole Surgery Through Automated Quantitative Analysis of Spectral-Domain Optical Coherence Tomography (SD-OCT) Scans.
abstract: OBJECTIVE
  To determine the value of topographic spectral-domain optical coherence tomography (SD-OCT) imaging features assessed after macular hole repair surgery in predicting visual acuity (VA) outcomes.
  
  
  METHODS
  An automated algorithm was developed to topographically outline and quantify area, extent, and location of defects in the ellipsoid zone (EZ) band and inner retina layers in SD-OCT scans. We analyzed the correlation of these values with VA in longitudinal observations from 35 patients who underwent successful macular hole surgery, in their first observation after surgery (within 2 months), and in a single observation within 6 to 12 months after surgery. Image features assessed at the first visit after surgery were also investigated as possible predictors of future VA improvement.
  
  
  RESULTS
  Significant correlation with longitudinal VA was found for the extent, circularity, and ratio of defects in EZ band at the fovea and parafoveal regions. The ratio of defects in EZ band at the fovea, temporal-inner, and inferior-inner macula regions showed significant strong correlation with VA within 6 to 12 months post surgery. Patients with worse vision outcome at such time also had a significantly higher rate of inner retinal defects in the superior-outer region in their first postsurgery observation.
  
  
  CONCLUSIONS
  A lowering extent of EZ band defects in the foveal and parafoveal regions is a good indicator of postsurgery VA recovery. Attention should also be given to postsurgical alterations in the inner retina, as patients with more extensive atrophic changes appear to have slower or worse VA recovery despite closure of the macular hole.
authors.affiliation: Department of Radiology Stanford University, Stanford, California, United States.
authors.forename: Luis
authors.initials: L
authors.lastname: de Sisternes
authors.affiliation: Department of Radiology Stanford University, Stanford, California, United States 2Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, California, United States.
authors.forename: Julia
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Radiology Stanford University, Stanford, California, United States 3Department of Medicine (Biomedical Informatics), Stanford University, Stanford, California, United States.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Rubin
authors.affiliation: Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, California, United States.
authors.forename: Theodore
authors.initials: T
authors.lastname: Leng
mesh_terms: D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D011184:Postoperative Period; D011379:Prognosis; D020127:Recovery of Function; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*