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Karl E. Waite, Michael D. Bennett, Eugene Ng, Jamison R. Ridgeley; SD-OCT Morphologic Changes Seen After Macular Hole Closure Utilizing Silicone Oil Tamponade. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2209.
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To characterize morphologic retinal changes after macular hole closure with Spectral Domain OCT and relate these changes to visual acuity.
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.
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.
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.
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