Long-term anatomical and functional outcomes of idiopathic macular hole surgery. the yield of spectral-domain OCT combined with microperimetry

摘要

Background: To evaluate the correlations between anatomical and functional changes studied with microperimetry (MPM) and spectral-domain OCT (SD-OCT) in patients after successful repair of idiopathic macular hole (MH). Methods: Monocentric, retrospective, interventional study in 23 eyes of 23 patients who underwent successful surgery for MH defined as closure of the hole, at least 1 year before. Reported data were pre- and postoperative best-corrected visual acuity (BCVA), retinal sensitivity values on MPM, macular and foveal thicknesses, and retinal anatomic lesions on SD-OCT. Results: Macular sensitivity (MS) and foveal sensitivity (FS) were lower and the number of lesions of the outer retinal layers was higher in patients with a poorer postoperative VA (P = 0.029, P = 0.011 and P = 0.003 respectively). Preoperative MH size was lower and MS and FS were better in patients with a preserved junction line between the inner and outer segments of photoreceptors (IS/OS) (P = 0.045, P = 0.001, and P = 0.001 respectively). Better postoperative VA was correlated with better preoperative VA (P = 0.012, r = 0.513). Postoperative VA was correlated with MS and FS (P = 0.032, r = 0.449, and P = 0.019, r = 0.483 respectively). Greater foveal thickness was associated with better postoperative VA (P = 0.020, r = 0.482). Conclusion: Postoperative outer retinal layer integrity is associated with better final retinal sensitivity. Further studies are warranted to assess the role of SD-OCT and microperimetry in the pre- and postoperative evaluation of idiopathic macular holes.