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Ramin Tadayoni, Elise Boulanger-Scemama, Aude Couturier, Rabih Hage, Pascale Massin, Alain Gaudric; Foveal Detachment after Idiopathic Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):310.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the incidence and dimensions of foveal detachment (FD) following idiopathic macular hole (MH) surgery and to identify its clinical and anatomical risk factors.
A retrospective analysis was performed on 100 eyes from 100 consecutive patients who had undergone vitrectomy and gas tamponade for idiopathic macular hole. We specifically studied postoperative FD, taking care to distinguish it from outer foveal defect in photoreceptors lines without actual detachment. The anatomical features of FD were analyzed on postoperative spectral-domain optical coherence tomography (SD-OCT) and correlated with morphological and clinical data at baseline, 1 month and 3 months postoperatively. The size of defect was measured and compared with preoperative MH base diameter.
A FD was found on postoperative SD-OCT of 18% (12/65) of eyes at 1 month and only 4% (3/70) of eyes at 3 months after surgery. The base diameter of the defect at 1 month (371±92 μm) and 3 months (341±104 μm) postoperatively were always smaller than the preoperative MH base diameter (766±203 μm). The only factor significantly associated with persistence of a FD was a higher preoperative central macular height (P=0.012). Results showed no statistical difference in postoperative visual acuity between eyes with and without FD and all cases reattached spontaneously.
This is the first SD-OCT study of post-operative FD after MH surgery. These FD were rare, especially at 3 months, and reattached spontaneously. The base diameter of FD was always smaller than the preoperative MH base diameter, and its presence was correlated to the macular height, suggesting that these FD are remnant of the preoperative macular elevation.
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