Abstract
Purpose: :
To characterize morphologic retinal changes after macular hole closure with Spectral Domain OCT and relate these changes to visual acuity.
Methods: :
Retrospective review of consecutive patients undergoing macular hole repair via Pars Plana Vitrectomy, ILM peel, and silicone oil tamponade at a single center. Pre-operative and post-operative SD OCT images were compared and morphologic differences were noted. Morphologic differences were then compared to final visual outcome.
Results: :
40 patients were identified meeting the criteria. Macular hole closure was successful in all cases. Restoration of foveal contour and visual acuity improvement was seen in a majority of cases. Post-operative visual acuity was significantly improved in patients with restoration of the IS/OS junction.
Conclusions: :
After macular hole closure, the outer retinal architecture appears to correlate with visual improvement to a greater degree than inner retinal architecture. Patients with longstanding or recurrent macular holes are more likely to have abnormalities in the photoreceptor layer and a worse visual prognosis, compared to patients with acute macular holes. We suggest that evaluation of outer retinal anatomy, specifically the IS/OS junction, with SD-OCT be part of the pre-operative workup and that patients be counseled on the visual prognosis.
Keywords: macular holes • imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)