Evaluation of Correlation Between OCT Findings and Delayed Visual Acuity Improvement After Macular Hole Surgery.
10.3341/jkos.2008.49.5.763
- Author:
Ji Hong KIM
1
;
Ji Eun LEE
;
Boo Sup OUM
Author Information
1. Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea. jlee@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Delayed Gradual visual acuity (VA) improvement;
Macular hole surgery;
Optical Coherence Tomography (OCT)
- MeSH:
Absorption;
Eye;
Humans;
Macular Edema;
Retinal Perforations;
Retinal Pigment Epithelium;
Retinaldehyde;
Tomography, Optical Coherence;
Vision, Ocular;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2008;49(5):763-770
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We evaluated the relationship between the delayed visual acuity (VA) improvement and retinal features, including in the photoreceptor layer, after a successful macular hole surgery using optical coherence tomography (OCT) images during long-term post-operative observation. The goal was to find the mechanism in delayed VA improvement. METHODS: Postoperative OCT scans were analyzed in nine eyes of eight patients who underwent idiopathic macular hole surgery between June 2003 to June 2005. Horizontal and vertical OCT scans taken of the operated eyes immediately after absorption of intraocular gas and after VA improvement were exported to Adobe Photoshop 7.0. We measured changes in parameters of the central foveal thickness (central 1 mm area), photoreceptor layer thickness, relative reflectivity of photoreceptor to retinal pigment epithelium, and the defective area of photoreceptor layer. RESULTS: The median visual acuity was determined to be 0.2 (range: 0.15~0.3) at the VA unimproved period and 0.5 (range: 0.3~1.0) at VA improved period. The mean central foveal thickness decreased from 221.3 micrometer (range: 155~265 micrometer) to 191.2 micrometer (range: 150~231 micrometer), as VA improved (p=0.007). The mean photoreceptor layer thickness increased from 15.2 micrometer (range: 4.2~27.6 micrometer) to 22.6 micrometer (range: 4.2~35.8 micrometer) as VA improved (p=0.032), and mean relative reflectivity of photoreceptor layer increased from 0.43 (range: 0.08~0.67) to 0.48 (range: 0.10~0.70), as VA improved (p=0.415). The defective area of photoreceptor layer decreased from 70% (range: 90~45%) to 27% (range: 8~5), as VA improved (p=0.001). CONCLUSIONS: A decrease of the central foveal thickness and of photoreceptor layer defective signal, and an increase of photoreceptor layer thickness were observed on OCT during delayed vision improvement after a successful macular hole surgery. Improvement of macular edema and photoreceptor reorganization are suggested as important parts of the mechanism toward vision recovery.
