J Korean Ophthalmol Soc.  2008 Apr;49(4):583-588. 10.3341/jkos.2008.49.4.583.

Correlation of Preoperative Optical Coherence Tomography with Preand Postoperative Visual Acuity of Macular Hole

• Kim SJ
• Lee JE
• Oum BS

• KMID: 2211488
• DOI: http://doi.org/10.3341/jkos.2008.49.4.583

Abstract

PURPOSE: To evaluate the correlation between preoperative optical coherence tomography (OCT) parameters and pre- and post-operative visual acuity after macular hole surgery.
METHODS
Twenty-five eyes of 24 patients who underwent macular hole surgery with a postoperative follow-up longer than 6 months were studied. On enhanced preoperative horizontal and vertical OCT scans, various parameters including hole diameter, base diameter, total lesion diameter, and hole height were measured. Hole form factor (HFF) and macular hole index (MHI) were calculated. The correlation between the parameters and pre- and post-operative visual acuity, as well as visual acuity change, was analyzed.
RESULTS
There was a significant correlation between hole height and preoperative visual acuity (P=0.018). Better postoperative visual outcome was correlated with a smaller hole diameter, smaller total lesion diameter, and greater hole height (P=0.002, 0.043 and 0.037). HFF and MHI were correlated with visual acuity change (P=0.024 and <0.001)
CONCLUSIONS
The correlation between visual acuity and hole height suggests that the height represents the amount of neural tissue in the retina. Relatively greater improvement in visual acuity is expected in eyes with high HFF or MHI even when preoperative visual acuity is low.

Keyword

Macular hole; Optical coherence tomography

MeSH Terms

Eye
Follow-Up Studies
Humans
Retina
Retinal Perforations
Tomography, Optical Coherence
Visual Acuity

Figure

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  Figure 1. Preoperative parameters of macular hole on optical coherence tomography. HT=height; HD=hole diameter; BD= base diameter; TD=total diameter.

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  Figure 2. A case of tall macular hole with high hole form factor (HFF) and macular hole index (MHI). (A) Processed optical coherence tomography (OCT) image shows preoperative parameters. Visual acuity was 0.2. OCT reveals high hole height with extensive cystic changes of the neurosensory retina beyond the extent of the hole base. HFF and MHI were 1.3 and 0.9, respectively. (B) Postoperative 12 months OCT shows normal foveal contour and well‐ organized photoreceptor layer without defect. Visual acuity was 1.0.

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  Figure 3. A case of macular hole with low height, high hole form factor (HFF) and macular hole index (MHI). (A) Processed optical coherence tomography (OCT) image demonstrates a small macular hole with low height. The measured preoperative parameters are shown. Visual acuity was 0.08. HFF was 1.0 and MHI was 0.8. (B) Postoperative 6 month OCT shows residual outer retinal defect. Visual acuity was 0.32.

Reference

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