title: CORRELATIONS BETWEEN PREOPERATIVE RETINAL PIGMENT EPITHELIAL PROTRUSIONS AND POSTOPERATIVE OUTCOMES IN EYES WITH IDIOPATHIC MACULAR HOLES.
abstract: OBJECTIVE
  To determine the relationship between the alterations in the preoperative morphology of the retinal pigment epithelium (RPE) and the postoperative recovery after surgery to close an idiopathic macular hole (MH).
  
  
  METHODS
  Retrospective interventional case series. Fifty-nine eyes of 59 patients with an idiopathic MH were studied. Pars plana vitrectomy was performed with the removal of the internal limiting membrane. The best-corrected visual acuity was measured, and the retinal morphology, including the presence of small RPE protrusions at the bottom of MH, was determined by spectral domain optical coherence tomography before and at 1, 3, and 6 months postoperatively.
  
  
  RESULTS
  The mean age of the patients was 66.7 years. Forty eyes (68%) had preoperative alterations of the RPE. The minimal (P < 0.001) and the base (P < 0.001) diameters of the MH were significantly larger in eyes with preoperative RPE alterations. The best-corrected visual acuity was significantly worse at baseline (P = 0.014) and at 6 months postoperatively (P = 0.048) in the eyes with RPE alterations. The defect of the ellipsoid zone was significantly longer in eyes with baseline RPE alterations at 1, 3, and 6 months postoperatively (P < 0.001, P = 0.001, and P = 0.032).
  
  
  CONCLUSIONS
  The presence of RPE protrusions at baseline was significantly correlated with slower morphologic recovery and poorer visual acuity after MH closure.
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Baba
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nizawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Oshitari
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D020127:Recovery of Function / Q000502:physiology; D012167:Retinal Perforations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D055213:Retinal Pigment Epithelium / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D013223:Statistics as Topic; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy