Article Text

other Versions

PDF
Macular morphology and visual acuity after macular hole surgery with or without internal limiting membrane peeling
  1. Ulrik Correll Christensen1,
  2. Kristian Krøyer1,
  3. Birgit Sander1,
  4. Thomas M Jørgensen2,
  5. Michael Larsen1,
  6. Morten la Cour1
  1. 1 Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark;
  2. 2 Department of Optics and Plasma Research, Risø National Laboratory, Roskilde, Denmark
  1. * Corresponding author; email: ulrikchristensen{at}dadlnet.dk

Abstract

Aim: To examine postoperative macular morphology and visual outcome after 12 months in relation to internal limiting membrane (ILM) peeling versus no peeling, indocyanine green (ICG)-staining, and reoperation in eyes that achieved macular hole closure after surgery.

Methods: Seventy-four eyes with closed stage 2 or 3 macular holes were recruited from a randomized clinical trial comparing (1) vitrectomy without ILM peeling, (2) vitrectomy with 0.05 % isotonic ICG-assisted ILM peeling, and (3) vitrectomy with 0.15 % trypan blue-assisted ILM peeling. Contrast-enhanced Stratus optical coherence tomography was used to assess central foveal thickness (CFT), central photoreceptor layer thickness (CPRT), central photoreceptor layer disruption (PRD) and relative reflectivity of the outer nuclear layer (ONL-RR). Outcomes were correlated with best-corrected visual acuity (BCVA) 12 months after surgery.

Results: BCVA was correlated with CPRT and PRD. Regression analysis and receiver operating characteristics curve analysis showed that CPRT > 33 µm (odds-ratio = 12.5) and PRD < 177 µm (odds-ratio = 9.86) were highly predictive for regaining reading vision (≥ 69 early treatment of diabetic retinopathy study letters) 12 months after surgery. No significant difference was found in postoperative macular morphology between subgroups.

Conclusions: Poor vision after 12 months despite macular hole closure was associated with attenuation and disruption of the foveolar photoreceptor matrix. The extent of attenuation and disruption was independent of peeling and staining.

ClinicalTrials.gov Identifier: NCT00302328

Statistics from Altmetric.com

Footnotes

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.