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Morphologic and functional evaluation before and after successful macular hole surgery using spectral-domain optical coherence tomography combined with microperimetry.
Retina. 2012 Oct; 32(9):1733-42.R

Abstract

PURPOSE

To evaluate photoreceptor inner/outer segment (IS/OS) defects, best-corrected visual acuity (BCVA), macular sensitivity, and fixation stability to correlate morphologic changes with visual functional outcomes at different stages after macular hole surgery using spectral-domain optical coherence tomography combined with microperimetry.

METHODS

This study was an interventional, retrospective case series. Sixteen eyes of 16 patients with successfully operated idiopathic full-thickness macular holes were included in this study. The IS/OS defect maximal diameter and area, BCVA, central macular sensitivity, mean macular sensitivity, and fixation stability were measured using spectral-domain optical coherence tomography combined with microperimetry, preoperatively, and with a follow-up of 3 months postoperatively.

RESULTS

Both the IS/OS defect diameter and area improved after successful macular hole surgery (P < 0.001; P < 0.001). The BCVA, central macular sensitivity, mean macular sensitivity, and fixation stability of the central 2° also improved (P = 0.001; P = 0.004; P = 0.036; P = 0.031). Stable BCVA improvement was achieved as early as 1-month postoperation despite continuous repair of the IS/OS junction defect diameter and area and improvement in fixation and macular sensitivity within the first 3 months after surgery. The postoperative central macular sensitivity and mean macular sensitivity negatively correlated with preoperative linear IS/OS junction defect diameter (P = 0.033; P = 0.006) and the defect area (P < 0.001; P = 0.002). However, the postoperative BCVA and the improvement in BCVA, macular sensitivity, and fixation stability were not correlated with preoperative IS/OS defect diameter or area.

CONCLUSION

Continuous anatomical and functional improvements can be observed after successful microinvasive macular hole surgery. The preoperative extent of the IS/OS junction defect is of good predictive value for postoperative macular sensitivity. However, the factors that influence BCVA are multiple. Prediction of BCVA based on a single anatomical parameter or assessment of macular function only based on BCVA should be avoided.

Authors+Show Affiliations

Department of Ophthalmology, Peking University People's Hospital, Beijing, PR China.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22466479

Citation

Chen, Wei-chih, et al. "Morphologic and Functional Evaluation Before and After Successful Macular Hole Surgery Using Spectral-domain Optical Coherence Tomography Combined With Microperimetry." Retina (Philadelphia, Pa.), vol. 32, no. 9, 2012, pp. 1733-42.
Chen WC, Wang Y, Li XX. Morphologic and functional evaluation before and after successful macular hole surgery using spectral-domain optical coherence tomography combined with microperimetry. Retina. 2012;32(9):1733-42.
Chen, W. C., Wang, Y., & Li, X. X. (2012). Morphologic and functional evaluation before and after successful macular hole surgery using spectral-domain optical coherence tomography combined with microperimetry. Retina (Philadelphia, Pa.), 32(9), 1733-42.
Chen WC, Wang Y, Li XX. Morphologic and Functional Evaluation Before and After Successful Macular Hole Surgery Using Spectral-domain Optical Coherence Tomography Combined With Microperimetry. Retina. 2012;32(9):1733-42. PubMed PMID: 22466479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Morphologic and functional evaluation before and after successful macular hole surgery using spectral-domain optical coherence tomography combined with microperimetry. AU - Chen,Wei-chih, AU - Wang,Yu, AU - Li,Xiao-xin, PY - 2012/4/3/entrez PY - 2012/4/3/pubmed PY - 2013/1/19/medline SP - 1733 EP - 42 JF - Retina (Philadelphia, Pa.) JO - Retina VL - 32 IS - 9 N2 - PURPOSE: To evaluate photoreceptor inner/outer segment (IS/OS) defects, best-corrected visual acuity (BCVA), macular sensitivity, and fixation stability to correlate morphologic changes with visual functional outcomes at different stages after macular hole surgery using spectral-domain optical coherence tomography combined with microperimetry. METHODS: This study was an interventional, retrospective case series. Sixteen eyes of 16 patients with successfully operated idiopathic full-thickness macular holes were included in this study. The IS/OS defect maximal diameter and area, BCVA, central macular sensitivity, mean macular sensitivity, and fixation stability were measured using spectral-domain optical coherence tomography combined with microperimetry, preoperatively, and with a follow-up of 3 months postoperatively. RESULTS: Both the IS/OS defect diameter and area improved after successful macular hole surgery (P < 0.001; P < 0.001). The BCVA, central macular sensitivity, mean macular sensitivity, and fixation stability of the central 2° also improved (P = 0.001; P = 0.004; P = 0.036; P = 0.031). Stable BCVA improvement was achieved as early as 1-month postoperation despite continuous repair of the IS/OS junction defect diameter and area and improvement in fixation and macular sensitivity within the first 3 months after surgery. The postoperative central macular sensitivity and mean macular sensitivity negatively correlated with preoperative linear IS/OS junction defect diameter (P = 0.033; P = 0.006) and the defect area (P < 0.001; P = 0.002). However, the postoperative BCVA and the improvement in BCVA, macular sensitivity, and fixation stability were not correlated with preoperative IS/OS defect diameter or area. CONCLUSION: Continuous anatomical and functional improvements can be observed after successful microinvasive macular hole surgery. The preoperative extent of the IS/OS junction defect is of good predictive value for postoperative macular sensitivity. However, the factors that influence BCVA are multiple. Prediction of BCVA based on a single anatomical parameter or assessment of macular function only based on BCVA should be avoided. SN - 1539-2864 UR - https://www.unboundmedicine.com/medline/citation/22466479/Morphologic_and_functional_evaluation_before_and_after_successful_macular_hole_surgery_using_spectral_domain_optical_coherence_tomography_combined_with_microperimetry_ L2 - https://doi.org/10.1097/IAE.0b013e318242b81a DB - PRIME DP - Unbound Medicine ER -