J Korean Ophthalmol Soc.  2013 Nov;54(11):1731-1736. 10.3341/jkos.2013.54.11.1731.

Long-Term Changes in Foveal Microstructure after Macular Hole Surgery

• Jeong SH
• Kim JH
• Kim JW
• Kim CG
• Lee TG
• Cho SW

• KMID: 2217921
• DOI: http://doi.org/10.3341/jkos.2013.54.11.1731

Abstract

PURPOSE
To evaluate long-term outcome of foveal tissue elongation after macular hole (MH) surgery.
METHODS
This retrospective, observational case series was performed on patients who underwent MH surgery and were followed-up more than 12 months. Distance between the parafoveal edge of the outer plexiform layer (OPL) was defined as the inter-OPL distance and measured using optical coherence tomography images at 5 to 8 months postoperatively and at the last follow-up. The horizontal and vertical inter-OPL distances were compared between the 2 defined time points. In addition, further elongation of the foveal tissue in certain directions was defined as asymmetric elongation and was compared between the defined time points.
RESULTS
The early and late postoperative examination was performed at 6.3 +/- 1.1 (mean +/- standard deviation) months and 22.7 +/- 7.8 months, respectively. The horizontal inter-OPL distance was 552.3 +/- 130.5 microm and 502.8 +/- 139.3 microm at the defined time points, respectively and the vertical inter-OPL distance was 478.9 +/- 107.2 microm and 447.5 +/- 107.1 microm, respectively. Both horizontal and vertical inter-OPL distances were significantly shortened at the last postoperative examination (p < 0.001, p = 0.002, respectively). The degree of asymmetric elongation was 10.8 +/- 6.5% and 11.8 +/- 7.9% at the defined time points, respectively, and was not different between the defined time points (p = 0.426).
CONCLUSIONS
The long-term shortening of foveal tissue after MH surgery without progression of asymmetry may partially contribute to the long-term recovery of visual function after MH surgery.

Keyword

Elongation; Fovea; Macular hole; Optical coherence tomography

MeSH Terms

Follow-Up Studies
General Surgery*
Humans
Retinal Perforations*
Retrospective Studies
Tomography, Optical Coherence

Figure

• 

  Figure 1. Measurements based on spectral domain optical coherence tomography image. The distance between the edges of the outer plexiform layer (OPL) was defined as the inter-OPL distance. The distance between the center of the foveal cystic space and the superior edge of OPL indicates superior length (S), whereas the distance between the center of the foveal cystic space and the inferior edge of OPL indicates inferior length (I).

• 

  Figure 2. Optical coherence tomography images taken preoperatively (A) and at 5 months (B) and at 30 months (C) after macular hole surgery showing long-term changes in foveal tissue after the surgery.

Reference

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