title: Predicting anatomical results of surgical treatment of idiopathic macular hole.
abstract: OBJECTIVE
  To determine the parameters most informative in predicting the anatomical results of surgical treatment of idiopathic full-thickness macular hole (IMH).
  
  
  METHODS
  One hundred and sixty-two consecutive patients (170 eyes) after primary operation for IMH were enrolled. Outcomes were classified as anatomical success when both IMH closure and restoration of the outer retinal structure were achieved. "Prospective" group included 108 patients (115 eyes) followed with optical coherence tomography (OCT) and microperimetry for 1y after surgery. Potential prognostic criteria, except microperimetry data, were tested in "retrospective" group (54 patients, 55 eyes). Prognostic value of each parameter was determined using receiver operating characteristic (ROC) analysis. Combined predictive power of the best prognostic parameters was tested with the use of linear discriminant analysis.
  
  
  RESULTS
  IMH closure was achieved in 106 eyes (92%) in the prospective group and 49 eyes (89%) in the retrospective group. Despite anatomical closure, the outer retinal structure was not restored in two eyes in the first group and in one eye in the second group. Preoperative central subfield retinal thickness demonstrated the best discriminatory capability between eyes with anatomical success and failure: area under the ROC-curve (AUC) 0.938 (95% CI: 0.881-0.995), sensitivity 64% at fixed specificity 95% (cut-off value 300 µm) in the prospective group; sensitivity 57% and specificity 90% in the retrospective group. Other continuous parameters except tractional hole index (AUC: 0.796, 95% CI: 0.591-1.000) had significantly lower AUCs (P<0.05). The best combination of the parameters, established by discriminant analysis in the prospective group, could not confirm its predictive value in the retrospective group.
  
  
  CONCLUSIONS
  Preoperative central subfield retinal thickness is a strong and probably the best predictor of anatomical results of IMH surgical treatment.
authors.affiliation: The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow 127486, Russia.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Shpak
authors.affiliation: The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow 127486, Russia.
authors.forename: Dmitry O
authors.initials: DO
authors.lastname: Shkvorchenko
authors.affiliation: The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow 127486, Russia.
authors.forename: Ilias Kh
authors.initials: IKh
authors.lastname: Sharafetdinov
authors.affiliation: The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow 127486, Russia.
authors.forename: Olga A
authors.initials: OA
authors.lastname: Yukhanova
keywords: anatomical surgery outcome; central subfield retinal thickness; idiopathic full-thickness macular hole; optical coherence tomography; prognosis; receiver operating characteristic analysis