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R. Keshavamurthy, V. S. Brar, S. K. Gupta, S. Grover, K. V. Chalam; Foveal Microstructure as Delineated by Spectral-Domain OCT Accurately Predicts Functional Outcome on Microperimetry After Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1335.
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To study the correlation between foveal microstructure on Spectral-domain Optical Coherence Tomography (SD-OCT) with functional outcome on microperimetry after macular hole surgery.
Retrospective review of charts of patients who underwent macular hole surgery with a minimum follow up of 12 months. Data collection included pre and post-operative best corrected Snellen visual acuity (BCVA), converted to LogMAR scale, central subfield foveal thickness (CSFT), presence or absence of Inner Segment-Outer Segment (IS-OS) line changes on SD-OCT and visual sensitivity (in decibels) on microperimetry (MP-1, Nidek, Japan). CSFT was recorded off the automated measurements generated by SD-OCT (Spectralis, Heidelberg, Germany). The mean foveal sensitivity (MFS) on MP-1 was calculated by taking the average sensitivity values of 5 points within 500 microns of centre of fovea. Based on the visual outcome, patients were divided into 2 groups: group 1 had a visual improvement of more than 2 lines whereas patients who had less than or equal to one line improvement were included in group 2. Data collected from SD-OCT was correlated with MFS on MP-1.
18 eyes of 16 patients, who had successful anatomical closure which was documented both clinically and on SD-OCT, were included in the study. Mean age of the patients was 75.4 years and 81.2 % (13/16) of patients were females. Overall, the mean BCVA changed from 0.81 + 0.41 preoperatively to 0.69 + 0.46 postoperatively (p=0.33). There were 12 eyes (10 patients) in group 1 and 6 eyes (6 patients) in group 2. On the SD-OCT, the mean CSFT was 261.7+ 69.1 microns overall, 259.9 + 54.5 microns in group 1, 263.3 + 113.1 microns in group 2 (p=0.8). All the patients in group 1 had a continuous IS-OS line on SD-OCT compared to none in group 2 (p=0.05). Overall, the MFS on MP-1 was 9.6 + 5.4 db and 12.2 + 3.8 , 4.2 + 3.9 db, in group 1 and 2, respectively (p =0.005). Positive correlation was found between MFS on MP-1 and postoperative BCVA (r=0.71, p=0.002).
Visual foveal sensitivity on Microperimetry and establishment of a continuous IS-OS line on SD-OCT correlated with good recovery of vision in patients who had successful anatomical closure of macular hole.
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