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J. Jung, K. Kim; Morphological Prognostic Factors of Postoperative Visual Outcome in Idiopathic Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1342.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the morphological prognostic factors of postoperative visual outcome in idiopathic macular hole surgery.
Fifty one patients (fifty one eyes) who had undergone vitrectomy for idiopathic macular hole and followed up for at least 6months were included. Patients with the postoperative visual acuity (VA) < 20/50 and with VA ≥ 20/50 were designated as group 1 and group 2 respectively. As a subgroup, patients with postoperative normal-ranged foveal thickness (33 eyes) were divided into A and B group which had the postoperative VA < 20/50 or ≥ 20/50 respectively. Various morphological factors including preoperative base diameter (BD), minimum diameter (MD), hole height (HH), macular hole index (MHI), tractional hole index (THI), diameter hole index (DH) and hole form factor (HFF), and postoperative foveal thickness and foveal contour were analyzed by using optical coherence tomography (OCT) in all patients.
As the preoperative factors, group 2 (23 eyes) comparing to group 1 (28 eyes) had shorter BD (669.78±288.62µm vs. 999.28±583.35µm) and MD (338.65±197.03µm vs. 547.57±187.84µm ) (p=0.017 & 0.000, respectively), and larger MHI (0.67±0.25 vs. 0.46±0.21) and THI (1.49±0.89 vs. 0.80±0.35) (p=0.002 & 0.001, respectively). As the postoperative factors, group 2 had better foveal contour (65.2% vs. 32.1%) and thicker fovea (174.57±40.03 µm vs. 147.25±53.32 µm) (p=0.048 & 0.019, respectively). In subgroup, only preoperative THI was significantly larger in group B (18 eyes) than in group A (13 eyes) (1.25±0.57 vs. 0.81±0.31) (p=0.013).
This study showed that the various morphological factors using OCT, especially THI and foveal contour, seemed to be helpful in estimation of the functional outcome in macular hole surgery.
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