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CY Shih, H Rodriguez-Coleman MD, K Langton CRA, S Chang MD; Pre-operative Use of Optical Coherence Tomography for Predicting Post-operative Visual Outcome in Macular Hole Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4405.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the predictive value of optical coherence tomography (OCT) in the pre-operative evaluation of macular holes by correlating pre & postoperative visual acuity to factors such as macular hole & retinal detachment size. Methods: A cross-sectional study was performed of 113 eyes of 103 patients with full-thickness macular holes as documented by OCT. The patients were divided into non-surgical and surgical groups. The outcomes examined were pre and postoperative visual acuity. The dependent variables included macular hole & retinal detachment size, age, gender, refraction, quality of native lens, best corrected pre and postop visual acuity, previous failed macular hole surgery, cause (idiopathic vs. traumatic), and duration. Concurrent medical illnesses & ophthalmologic conditions were also noted. Multiple cross-sectional tomographic images were obtained using OCT. The macular holes were staged using Gass's criteria and all clinical observations were confirmed intra-operatively. Correlations between patients' pre and postoperative vision, macular hole & retinal detachment size, and other independent variables were examined using SPSS. Results: The average macular hole & retinal detachment sizes were 517µ & 1149µ in the non-surgical group (n=41), and 464µ &1030µ in the surgical group (n=72). Preoperatively, 40% of the surgical group had a visual acuity of 20/70-20/100 and 39% of the non-surgical group had a VA of 20/150-20/400. Postoperatively, 53% of the surgical group attained a vision of 20/40 or better and had average macular hole & retinal detachment sizes of 392µ & 960µ respectively. Postoperative vision was significantly correlated (p<0.05) to macular hole & retinal detachment size, preop vision, stage, previous surgery, recurrence, and duration. Other medical conditions and clinical observations which resulted in worse postoperative visual acuity included diabetes mellitus, staphyloma, and horse shoe tears. In the non-surgical group, macular hole & retinal detachment size were also correlated with visual outcome. Conclusion: This study shows that macular hole & retinal detachment size as measured by OCT can be correlated with vision pre and postoperatively. This could be used to predict postoperative visual outcomes in patients with macular holes, however further studies are needed.
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