Abstract
Purpose :
To investigate the changes of outer nuclear layer in healing process in idiopathic, full-thickness macular holes(MH) according to postoperative outer retinal restoration.
Methods :
In this retrospective study, we analyzed clinical records and optical coherence tomography (OCT) imaging data from 56 eyes of 55 consecutive patients diagnosed with macular holes (MH) who underwent vitrectomy. We only included patients who achieved successive hole closure during a 12-month follow-up period. Data on the morphological characteristics of the macular hole before vitrectomy and the thickness of the outer nuclear layer (ONL) in the 1mm and 3mm ETDRS circle were collected at 1, 6, and 12 months after surgery. Additionally, we assessed the restoration of the ellipsoid zone (EZ) at the 12-month postoperative follow-up.
Results :
At 12 months postoperative, 40 eyes (71.4%) showed continuous EZ restoration and showed better visual acuity than those with EZ disruption (0.33 vs 0.70, P = 0.006). Patients with continuous EZ restoration at 1, 6, and 12 months had a thicker foveal 1mm outer nuclear layer (ONL) compared to those with EZ disruption (all P < 0.001). Additionally, in the EZ restoration group, the temporal and inferior 3mm circle exhibited a thicker ONL at 6 and 12 months compared to patients with EZ disruption (all P <0.05). When comparing the ONL thickness after surgery in each patient, the foveal 1mm zone showed an increase at 12 months compared to 6 months (71.9um vs. 69.0 um, P <0.001), while the temporal and inferior 3mm circle exhibited a decrease over time (P = 0.012, 0.001, respectively).
Conclusions :
Foveal restoration after macular hole surgery can lead to improved visual outcomes, and the thickness of the outer nuclear layer (ONL) may serve as an indicator of foveal restoration. During the healing process following macular hole surgery, there appears to be ONL movement in the parafovea, toward the center of the macula.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.