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T. Baba, E. Arai, M. Arai, T. Sugawara, Y. Mitamura, S. Yamamoto; Correlation of Visual Recovery and Presence of Photoreceptor Outer/Inner Segment Junction After Macular Hole Repair. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4114.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the relationship between the postoperative visual acuity (VA) and the detection of a photoreceptor inner and outer segment (IS/OS) junction by optical coherence tomography (OCT) in cases after macular hole (MH) repair.
Twenty-three eyes of 23 cases of idiopathic MH were examined retrospectively. The preoperative VA ranged from 0.09 to 0.7, and the estimated duration from onset was 1-16 (average 5.5) months. The stages of the MHs were: stage 1 in 1 eye, 2 in 5 eyes, 3 in 8 eyes, and 4 in 9 eyes. All eyes were successfully treated with pars plana vitrectomy accompanied by removal of the internal limiting membrane (stage 2 or more advanced cases) and cataract surgery. The postoperative VA and retinal images of the macular area by OCT3 at 1, 3 and 6 months were examined. The presence of IS/OS junction appeared as a distinct, highly reflective line just above the retinal pigment epithelial layer in the postoperative OCT images. The relationship between the presence of the IS/OS junction and the visual acuity was studied.
The IS/OS junction was detected postoperatively in 4 eyes at 1 month, 11 eyes at 3 months, and 16 eyes at 6 months. The VA was significantly better in eyes in which the IS/OS junction was detected than those not detected at 3 and 6 months postoperatively (P=0.0001 and P=0.006, respectively). A shorter estimated preoperative duration was associated with a higher incidence of an IS/OS junction at 6 months (P=0.033). The correlations between the presence of IS/OS junction and patients’ age, preoperative VA, and stage and size of MH were not significant.
The IS/OS junction observed by OCT was associated with good visual recovery in postoperative MH cases. The presence of IS/OS junction may be important for the visual recovery after MH repair.
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