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British Journal of Ophthalmology 2008;92:640-644; doi:10.1136/bjo.2007.136176
Copyright © 2008 by the BMJ Publishing Group Ltd.
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CLINICAL SCIENCE

Optical coherence tomography predictive factors for macular hole surgery outcome

J M Ruiz-Moreno1,2, C Staicu2, D P Piñero2, J Montero2, F Lugo2, P Amat2

1 Albacete Medical School, University of Castilla La Mancha, Albacete, Spain
2 Alicante Institute of Ophthalmology, VISSUM, Vitreo-Retinal Unit, Alicante, Spain

Correspondence to:
Mr D P Piñero, Alicante Institute of Ophthalmology, VISSUM, Vitreo-Retinal Unit, Alicante, Spain; dpinero{at}vissum.com

Aim: To evaluate the use of preoperative optical coherence tomography (OCT) findings as predictive factors for macular hole (MH) surgery outcomes.

Methods: 46 eyes from 46 patients with a diagnosis of MH were included in this study. In all cases, a pars plana 25-gauge vitrectomy with peeling of the internal limiting membrane was performed. Before and after surgery, a complete clinical examination and a detailed macular analysis, which included the MH minimum and base diameter, the MH height, the Macular Hole Index (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI), were performed. Predictive factors for visual prognosis after surgery were obtained by receiver operating characteristic curve analysis.

Results: Minimum and base diameter as well as THI and MHI correlated significantly (p<0.01, p = 0.01, p = 0.04, p = 0.03, respectively) with postoperative best spectacle corrected visual acuity at 3 months, but DHI and MH height did not. Cut-off values of 311 µm and 1.41 were obtained for the minimum diameter and THI, respectively, from receiver operating characteristic curve analysis, providing an acceptable sensitivity and specificity.

Conclusion: An MH minimum diameter of <311 µm or a THI >1.41 are predictive factors for a good visual prognosis after MH surgery.

Funding: This study was supported in part by a grant from the Spanish Ministry of Health, Instituto Carlos III, Red Temática de Investigación Cooperativa en Salud "Patología ocular del envejecimiento, calidad visual y calidad de vida" (RD07/0062).

Competing interests: None.






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Copyright © 2008 by the BMJ Publishing Group Ltd.