Abstract
Purpose :
To identify new biomarkers on spectral domain optical coherence tomography (SD-OCT) horizontal scans in patients with large macular holes (>400um diameter) that may help predict post-operative visual acuity (VA) outcomes.
Methods :
A retrospective chart review was conducted of patients who were diagnosed with large macular hole and had preoperative SD-OCT scans at Kansas University Medical Center over the last 10 years. Available scans were examined by 2 readers. Image-J software was used to measure macular hole diameter, number of border cysts, optical density of border cysts, optical density of overlying vitreous, and the angle at retinal margins of the macular hole. Data collected included LogMAR visual acuity, age, gender, optical density of various biomarkers, and macular hole diameter. The study was approved by the institutional review board of the University of Kansas School of Medicine.
Results :
Records of 375 patients with macular hole were reviewed. 21 patients met the study inclusion criteria (16 females, 5 males), with an average age of 73.6±5.6 years old. All patients had preoperative retinal cysts at the macular hole margin. Multiple regression analyses for postoperative visual acuity at 1 month demonstrated significant correlation with macular hole margin cyst number (average: 7±4 retinal cysts, Multiple R-value= -0.5, p-value: 0.02), and no significant correlation with total cyst area (p-value: 0.2). The optical density ratio (ODR) of retinal cysts and retinal margin angle measurements did not correlate with post-operative VA, (R-value = -0.1, p-value: 0.65) and (average angle: 55.3±9.5 degrees, R-value = -0.28, p-value: 0.44), respectively. Preoperative VA correlated significantly with postoperative VA, while macular hole diameter did not show significant correlation, (R-value: 0.3, p-value: 0.002) and (R-value: 0.3, p-value: 0.15), respectively.
Conclusions :
In this study cohort, the number of retinal margin cysts on horizontal SD-OCT scans had significant correlation with postoperative visual outcome in patients with large macular hole (>400um diameter). In addition, preoperative VA demonstrated a significant correlation with postoperative VA. Large prospective studies are needed to further elucidate the role of intraretinal cysts with large macular holes.
This is a 2020 ARVO Annual Meeting abstract.