BACKGROUND: To evaluate the prognostic value of foveal microstructures as determined using spectral-domain optical coherence tomography (SD-OCT) in eyes with surgically closed macular holes (MHs). METHODS: Thirty eyes of 30 patients that underwent successful vitrectomy for idiopathic MHs were studied. Best-corrected visual acuity (BCVA) and SD-OCT images of the fovea were examined preoperatively and at 2 weeks, 1, 3, and 6 months postoperatively. The SD-OCT characteristics evaluated included MH diameter, external limiting membrane (ELM) defect diameter, photoreceptor inner/outer segment (IS/OS) junction defect diameter, the presence or absence of subretinal fluid (SRF), central foveal thickness (CFT), and outer foveal thickness (the distance between the ELM and the inner border of the retinal pigment epithelium). The correlations between SD-OCT parameters and BCVA were analyzed. RESULTS: The IS/OS junction defect diameter was most strongly correlated with BCVA at 2 weeks and 1 month postoperatively while outer foveal thickness showed the strongest correlation with BCVA at 3 and 6 months. Outer foveal thickness gradually increased over the follow-up period. Among the pre- and early postoperative quantitative parameters, the only significant predictors of BCVA at 6 months were the IS/OS junction defect diameter and outer foveal thickness at 2 weeks (p = 0.012, p = 0.018, respectively). Disrupted ELM at 2 weeks was also associated with significantly poorer BCVA at 6 months (p < 0.001). CONCLUSIONS: An increase in outer foveal thickness, indicating photoreceptor outer segment restoration, is an important factor for visual recovery after MH surgery.
BACKGROUND: To evaluate the prognostic value of foveal microstructures as determined using spectral-domain optical coherence tomography (SD-OCT) in eyes with surgically closed macular holes (MHs). METHODS: Thirty eyes of 30 patients that underwent successful vitrectomy for idiopathic MHs were studied. Best-corrected visual acuity (BCVA) and SD-OCT images of the fovea were examined preoperatively and at 2 weeks, 1, 3, and 6 months postoperatively. The SD-OCT characteristics evaluated included MH diameter, external limiting membrane (ELM) defect diameter, photoreceptor inner/outer segment (IS/OS) junction defect diameter, the presence or absence of subretinal fluid (SRF), central foveal thickness (CFT), and outer foveal thickness (the distance between the ELM and the inner border of the retinal pigment epithelium). The correlations between SD-OCT parameters and BCVA were analyzed. RESULTS: The IS/OS junction defect diameter was most strongly correlated with BCVA at 2 weeks and 1 month postoperatively while outer foveal thickness showed the strongest correlation with BCVA at 3 and 6 months. Outer foveal thickness gradually increased over the follow-up period. Among the pre- and early postoperative quantitative parameters, the only significant predictors of BCVA at 6 months were the IS/OS junction defect diameter and outer foveal thickness at 2 weeks (p = 0.012, p = 0.018, respectively). Disrupted ELM at 2 weeks was also associated with significantly poorer BCVA at 6 months (p < 0.001). CONCLUSIONS: An increase in outer foveal thickness, indicating photoreceptor outer segment restoration, is an important factor for visual recovery after MH surgery.
Authors: Christoph Scholda; Matthias Wirtitsch; Boris Hermann; Angelika Unterhuber; Erdem Ergun; Harald Sattmann; Tony H Ko; James G Fujimoto; Adolf F Fercher; Michael Stur; Ursula Schmidt-Erfurth; Wolfgang Drexler Journal: Retina Date: 2006 Nov-Dec Impact factor: 4.256
Authors: Kakarala V Chalam; Ravi K Murthy; Shailesh K Gupta; Vikram S Brar; Sandeep Grover Journal: Eur J Ophthalmol Date: 2010 May-Jun Impact factor: 2.597
Authors: Mária Ferencz; Gábor Márk Somfai; Agnes Farkas; Illés Kovács; Balázs Lesch; Zsuzsa Récsán; János Nemes; György Salacz Journal: Am J Ophthalmol Date: 2006-11 Impact factor: 5.258
Authors: W E Benson; K C Cruickshanks; D S Fong; G A Williams; M A Bloome; D A Frambach; A E Kreiger; R P Murphy Journal: Ophthalmology Date: 2001-07 Impact factor: 12.079
Authors: Ulrik C Christensen; Kristian Krøyer; Birgit Sander; Michael Larsen; Morten la Cour Journal: Ophthalmology Date: 2009-09-10 Impact factor: 12.079
Authors: José Maria Ruiz-Moreno; Francisco Lugo; Javier A Montero; David P Piñero Journal: Graefes Arch Clin Exp Ophthalmol Date: 2012-02-23 Impact factor: 3.117
Authors: Alexander A Shpak; Dmitry O Shkvorchenko; Ilias Kh Sharafetdinov; Olga A Yukhanova Journal: Int J Ophthalmol Date: 2016-02-18 Impact factor: 1.779