Work

Volumetric Optical Coherence Tomography Analysis of Visual and Surgical Outcomes in Patients With Full-Thickness Macular Hole

Year: 2025

Type: article

Abstract: Purpose: To investigate the relationship between preoperative volumetric optical coherence tomography (OCT) features of full-thickness macular holes (FTMHs), including intraretinal cysts and 3-dimensional hole symmetry, and both visual acuity outcomes and surgical prognosis in patients with FTMH. Methods : This multicenter, retrospective cohort study assessed patients with FTMH who underwent pars plana vitrectomy from 2017 to 2022. In-depth manual segmentation of each pre- and postoperative OCT volumetric scan (60 B-scans per volume) was performed by 3 graders. Correlations between preoperative cystoid volume and FTMH symmetry and preoperative visual acuity, preoperative minimum linear diameter (MLD), improvement in visual acuity at 6 months postsurgery, and FTMH closure rate postsurgery were assessed using linear regression models, adjusted for baseline lens status, duration of symptoms, and MLD. Results: A total of 69 eyes of 69 patients with FTMH were included. Mean (± SD) visual acuity was 0.69 ± 0.44 logMAR (Snellen 20/98) before surgery, and improved to 0.39 ± 0.23 logMAR at 6 months after surgery (Snellen 20/49). FTMH closure after a single surgery was 96%. Greater cystoid volume before surgery was associated with larger FTMH MLD ( P < .001), worse preoperative visual acuity ( P = .003), and greater visual acuity improvement at 6 months after surgery ( P = .02). Greater hole asymmetry before surgery was associated with smaller MLD ( P = .04), but not associated with preoperative visual acuity ( P = .74) or postoperative FTMH closure rates ( P = .19). Conclusions: This study on OCT volumetric measurements showed that intraretinal cystoid volume correlated with larger macular holes and greater visual acuity improvement while smaller macular holes tended to be more asymmetric.

Source: Journal of VitreoRetinal Diseases

DOI: 10.1177/24741264251388105