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SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY STUDY OF MACULAR STRUCTURE AS PROGNOSTIC AND DETERMINING FACTOR FOR MACULAR HOLE SURGERY OUTCOME

Ruiz-Moreno, José M. MD, PhD*,†; Arias, Luis MD, PhD; Araiz, Javier MD, PhD§; García-Arumí, José MD, PhD; Montero, Javier A. MD, PhD**; Piñero, David P. PhD††

doi: 10.1097/IAE.0b013e318285cc3b
Original Studies

Purpose: To evaluate postoperative spectral-domain optical coherence tomography findings after macular hole surgery.

Methods: Retrospective, interventional, nonrandomized study. Overall, 164 eyes of 157 patients diagnosed with macular hole were operated on by vitrectomy and internal limiting membrane peeling. Preoperative and postoperative best-corrected visual acuity and spectral-domain optical coherence tomography images were obtained. Two groups were considered on the basis of the postoperative integrity of the back reflection line from the ellipsoid portion of the photoreceptor inner segment: group A (disruption of ellipsoid portion of the inner segment line, 60 eyes) and group B (restoration of ellipsoid portion of the inner segment line, 104 eyes).

Results: Logarithm of the minimum angle of resolution best-corrected visual acuity improved significantly after the surgery of macular hole from a mean preoperative value of 0.79 ± 0.37 (range, 0.15–2.00) to a mean postoperative value of 0.35 ± 0.31 (range, 0.00–1.30) at the last follow-up visit (P < 0.01). Best-corrected visual acuity improved significantly in the 2 groups analyzed (all P < 0.01). A larger improvement was found in group B than in group A (P < 0.01).

Conclusion: Ellipsoid portion of the inner segment line reconstruction seems to be a good prognostic factor for visual rehabilitation after macular hole surgery.

Visual prognosis after macular hole surgery with internal limiting membrane peeling is associated with the reconstruction of the ellipsoid portion of the photoreceptor inner segment as observed in spectral-domain optical coherence tomography.

*Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain;

Vitreo-Retinal Unit, Alicante Institute of Ophthalmology, VISSUM, Alicante, Spain;

Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain;

§Clinical Surgical Institute of Ophthalmology, País Vasco University, Bilbao, Spain;

IMO, Hospital de la Vall d’Hebrón, Barcelona, Spain;

**Ophthalmology Unit, Pío del Río Hortega University Hospital, Valladolid, Spain; and

††Department of Optics, Pharmacology and Anatomy, Alicante University, Spain.

Reprint requests: José M. Ruiz-Moreno, MD, PhD, Departamento de Ciencias Médicas, Facultad de Medicina, Avenida de Almansa 14, 02006 Albacete, Spain; e-mail: josemaria.ruiz@uclm.es

Supported in part by a grant of the Spanish Ministry of Health, Instituto de Salud Carlos III, Red Temática de Investigación Cooperativa en Salud "Patología ocular del envejecimiento, calidad visual y calidad de vida" (RD07/0062/0019).

The authors report no financial or conflicts of interests to disclose.

Written informed consent was obtained after explaining the nature of the procedure before the surgical intervention to each patient.

Local ethic committees approved retrospective data gathering (Alicante Institute of Ophthalmology, VISSUM; Department of Ophthalmology, Bellvitge University Hospital; Clinical Surgical Institute of Ophthalmology, País Vasco University; IMO, Hospital de la Vall d’Hebrón).

© 2013 by Ophthalmic Communications Society, Inc.