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M. Shimozono, A. Oishi, M. Hata, S. Ito, H. Kimakura, M. Kimakura, K. Kumagai, Y. Kurimoto; Correlation Between Spectral-Domain Optical Coherence Tomography Findings and Visual Outcome After Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1321.
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To evaluate the prognostic value of postoperative morphological characteristics as determined using spectral-domain optical coherence tomography (SD-OCT) in eyes after successful macular hole (MH) surgery.
Eighteen eyes of 18 patients that underwent successful vitrectomy for idiopathic MH from October 2008 through June 2009 were studied. Best-corrected visual acuity (BCVA) and SD-OCT (Spectralis®, Heidelberg Engineering) images of the fovea were examined at 2 weeks, 1, 3, and 6 months after surgery. We assessed the external limiting membrane (ELM) defect diameter, the photoreceptor inner/outer segment junction (IS/OS) defect diameter, the presence or absence of subretinal fluid, the total foveal thickness, the outer foveal thickness (the distance between the ELM and the inner border of the retinal pigment epithelium), and the outer nuclear layer thickness at the fovea. These morphologic parameters were correlated with logMAR BCVA.
Among all morphologic parameters analyzed, the IS/OS defect diameter was most strongly correlated with logMAR BCVA 2 weeks after surgery (r = 0.658, P = 0.003), whereas the outer foveal thickness showed the strongest correlation with logMAR BCVA from 1 to 6 months (1 month: r = -0.482, P = 0.043; 3 months: r = -0.597, P = 0.009; 6 months: r = -0.818, P = 0.013). Among the SD-OCT findings 2 weeks after surgery, the ELM defect diameter showed a strong correlation with logMAR BCVA at 6 months (r = 0.801, P = 0.009).
An increase in the outer foveal thickness, which implies the photoreceptor outer segment restoration, is important for visual recovery after MH surgery. The ELM status in the early postoperative period may be useful as a predictor of long-term visual outcome.
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