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Thanvi Vatti, Henry Li, Sachin Singh, Kanika Seth, Carolina C S Valentim, Rishi P Singh, Katherine E Talcott; Association of Macular Hole Intraretinal Fluid and Visual Acuity. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3755 – F0176.
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© ARVO (1962-2015); The Authors (2016-present)
The degree of variability in intraretinal fluid (IRF) and configuration in patients with macular holes (MHs) has prompted studies to evaluate its prognostic value. This study investigates the association between preoperative intraretinal fluid (IRF) area and preoperative and postoperative in surgically repaired idiopathic MH. This study further evaluates other prognostic indices related to MH repair which may assist clinicians’ understanding of MH operative management.
A retrospective cohort study of 251 patients who were diagnosed with idiopathic MH and IRF in the edges of the hole and underwent successful surgical repair were selected for the study. OCT scans were segmented by expert readers to obtain IRF area. Preoperative and postoperative best visual acuity (BVA) at 1,3, and 6 months were collected along with associated MH characteristics such as size, staging, postoperative closure status, type of closure (type I vs type II) and preoperative and postoperative central subfield thickness (CST). Associations between IRF area and these variables were evaluated using Spearman’s correlation analysis.
At preoperative baseline, the mean(SD) BVA was 46.4(19.03) and mean(SD) CST was 366.11(77.75). Preoperative IRF area was moderately correlated with preoperative BVA (r = -0.32, p < 0.001), negligibly correlated with postoperative BVA at 1, 3, 6 months (r = -0.14, p = 0.026; (r = -0.21, p < 0.001; r = -0.19, p < 0.001, respectively). Preoperative IRF area was strongly correlated with MH minimum linear diameter (r = 0.56, p < 0.001) and MH base diameter (r = 0.65, p < 0.001), moderately correlated with baseline CST (r = 0.36, p < 0.001) and negligibly with 6-month CST (r = -0.2, p = 0.01). Relationships between IRF and MH closure status (r = 0.048, p = 0.45) and closure type (r = 0.047, p = 0.47) were not statistically significant.
Preoperative IRF area in patients with idiopathic MH demonstrated a moderate correlation with preoperative BVA and a negligible/weak correlation with postoperative BVA up to 6 months, suggesting that vision may not have a clinically significant relationship with IRF in the setting of MH. Further, this study reinforced previous findings that preoperative IRF was strongly correlated with MH size.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Correlations between IRF and BVA. A. Baseline BVA, B. Postoperative BVA at 1 month, C. Postoperative at 3 months, and D. Postoperative at 6 months
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