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Prognostic factors in vitrectomy for lamellar macular hole assessed by spectral‐domain optical coherence tomography
Author(s) -
Lee Christopher S.,
Koh Hyoung J.,
Lim Hyung T.,
Lee Kyu S.,
Lee Sung C.
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.02456.x
Subject(s) - optical coherence tomography , vitrectomy , macular hole , lamellar structure , ophthalmology , coherence (philosophical gambling strategy) , medicine , tomography , optics , materials science , physics , radiology , visual acuity , quantum mechanics , composite material
. Purpose: To evaluate the association between the macular structure on spectral‐domain optical coherence tomography (SD‐CT) and visual outcome after vitrectomy for lamellar macular hole (LMH). Methods: Best‐corrected visual acuity (VA) and SD‐OCT images of the macula were assessed before and after surgery in 30 eyes of 30 patients with a LMH. Preoperative VA and SD‐OCT features were investigated as predictors of surgical outcome. Results: Mean patient age was 65 years with female predominance (77%). Visual acuity improved in 19 eyes (63%) with an overall mean improvement of 1 Snellen line (from 20/65 to 20/50; p = 0.002) at a mean of 18 months after vitrectomy. Subgroup analysis showed that statistically significant visual benefit was only observed in patients with an intact photoreceptor inner segment/outer segment (IS/OS) junction (p = 0.003), with foveal thickness bigger than 100 μm (p = 0.004) and with initial VA better than 20/100 (p = 0.003). The most efficient model to predict final VA was the combination of preoperative VA and the presence or absence of IS/OS disruption ( r 2 = 0.77, p < 0.001). Conclusions: Poor initial VA, the presence of a disrupted IS/OS junction or a thin fovea on preoperative SD‐OCT predicted poor vision outcome after LMH surgery.