Influences of OCT image on the prognosis of visual outcomes among patients with idiopathic macular holes

• Main Authors: Jian-Ping Gao, Xiao-Jian Guo
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2013-11-01
• Series: Guoji Yanke Zazhi
• Subjects: idiopathic macular hole; vitrectomy; internal limiting membrane peeling; OCT; macular hole index; postoperative best corrected visual acuity
• Online Access: http://www.ies.net.cn/cn_publish/2013/11/201311038.pdf

AIM:To observe the optical coherence tomography(OCT)images of idiopathic macular hole(IMH)on patients before and after vitrectomy and internal limiting membrane peeling(ILMP)surgery, and to analyze the relationship between the macular hole configuration and the postoperative best corrected visual acuity so as to offer a potential index to effectively predict visual outcome in eyes with idiopathic macular holes. <p>METHODS: A total of 32 consecutive patients of IMH(7 males, 25 females)receiving the operation of PPV and ILMP were performed with routine ophthalmologic and OCT examination before and after the operation. The best-corrected visual acuity(BCVA)in the follow-up period was recorded. The minimum diameter, the base diameter, the hole height before the operation, and the macular retinal thickness before and after the operation were measured respectively by the analytical model of OCT. The correlation between macular hole index(MHI)and BCVA post operation was analyzed using SPSS 13.0.<p>RESULTS: The negative correlation was observed between the post operative BCVA and the minimum diameter and the base diameter before the operation(<i>r</i>=-0.524, -0.610, <i>P</i><0.01); There were no significant correlation between the post operative BCVA and the hole height and the macular retinal thickness(<i>r</i>=-0.064, 0.003, <i>P</i>>0.05). The positive correlation was observed between the postoperative BCVA and the MHI before operation(<i>r</i>=0.457, <i>P</i><0.01); The cut-off value of MHI was defined as 0.5 by clinical observation. Postoperative BCVA in the MHI ≥0.5 group was much better than that in the MHI<0.5 group(Mann-Whitney Test, <i>U</i>=30.0, W=135, <i>P</i><0.01). The postoperative BCVA of patients with IMH was much better than that before the operation.<p>CONCLUSION: The smaller the minimum diameter and the base diameter is, the better the post operative BCVA. The MHI is easy to calculate, and patients of MHI ≥0.5 have a better postoperative BCVA, MHI can be used as clinical evaluation-index for operation selection. The PPV combined with IMLP can effectively treat the IMH based on the OCT result.