Correlations between intraretinal cystoid cavities and pre- and postoperative characteristics of eyes after closure of idiopathic macular hole

Abstract

intraretinal cystoid cavities have been detected at the edges of macular holes (MHs) but their clinical characteristics and their relationship to the MH variables have not been determined. We measured the areas of the intraretinal cystoid cavity in 111 eyes with MHs in the OCT images preoperatively. Our results showed that the intraretinal cystoid cavities were located in the Henle fiber layer-outer nuclear layer (HFL-ONL) complex in 106 eyes and in the inner nuclear layer (INL) in 89 eyes. All were resolved after the initial vitrectomy to close the MH. the mean area of the cystoid cavity was greater in the HFL-ONL complex (55.9 ± 42.7 × 10 3 μm 2 ) than in the INL (9.1 ± 9.8 × 10 3 μm 2 ; P < 0.001). The area of the cystoid cavities was significantly correlated with the basal MH size (r = 0.465,P < 0.001), the external limiting membrane height (r = 0.793, P < 0.001), and the maximum retinal thickness (r = 0.757, P < 0.001). The area of the cystoid cavities was significantly correlated with the preoperative best-corrected visual acuity (BCVA; r = 0.361, P < 0.001), but not with the postoperative BCVA or the integrity of any of the outer retinal microstructural bands. the presence of intraretinal cystoid cavities was related to some morphological characteristics, but not to the postoperative BCVA or the restoration of the outer retinal bands.An idiopathic macular hole (MH) is found more commonly in the eyes of middle-aged and older individuals and can cause metamorphopsia and a decrease of the best-corrected visual acuity (BCVA). There are several suggestions on the mechanisms causing the formation of a full-thickness MH. Gass suggested that a MH begins by a tangential traction of the perifoveal vitreous cortex on the foveal retina which results in a dehiscence that progresses to a full-thickness MH 1,2 .Optical coherence tomography (OCT) has enabled clinicians to evaluate the foveal microstructures in eyes with a MH. Recent studies have determined that a MH is initially formed by a perifoveal posterior vitreous detachment (PVD) which causes an anteroposterior vitreomacular traction (VMT) 3-5 .Intraretinal cystoid cavities at the edges of a MH have been recognized in the images obtained by the early OCT devices 6 . These intraretinal hyporeflective spaces, the intraretinal cystoid cavities, are frequently observed around the edges of MHs 7 . However, the area of intraretinal cystoid cavities varies among eyes with a MH, and the clinical features of these eyes have not been quantified.Recent advances in the surgical techniques for closing a MH have improved the anatomical closure rates and the postoperative BCVAs. However, even after a successful closure of a MH, the postoperative BCVA can be unsatisfactory in some cases. To predict the postoperative BCVA, several preoperative OCT features such as the basal and minimum MH size 8,9 and the maximum retinal thickness 10 have been evaluated. Several investigators have reported that the degree of disruption of the microstructures of the photoreceptors in the preoperativ...

Role of intraretinal cysts in the prediction of postoperative closure and photoreceptor damages of the idiopathic full-thickness macular hole

“…There was a report that the closure rate of the hole could be increased if CME was treated with topical therapy in secondary FTMH [ 20 ]. Moreover, only a few studies have shown that it is associated with preoperative BCVA [ 21 ] and metamorphopsia [ 22 ]. Although the presence of IRC is assumed to have a significant effect on the morphological changes of MH, there have been no studies related to postoperative MH closure.…”

The Importance of Anatomic Configuration and Cystic Changes in Macular Hole: Predicting Surgical Success with a Different Approach

“…Various indexes have been developed to estimate the results of these OCT measurements, including hole form factor (HFF), MH index (MHI), and tractional hole index (THI) [15][16][17][18]. At the same time, some studies have evaluated the MH area (HA) as well as the cyst areas around MH (CA) by subjecting OCT images to analysis using different software, such as Image J, which has many disadvantages [19,20].…”

The Importance of Anatomic Configuration and Cystic Changes in Macular Hole: Predicting Surgical Success with a Different Approach

“…Various indexes have been developed to estimate the results of these OCT measurements, including hole form factor (HFF), MH index (MHI), and tractional hole index (THI) [15][16][17][18]. At the same time, some studies have evaluated the MH area (HA) as well as the cyst areas around MH (CA) by subjecting OCT images to analysis using different software, such as Image J, which has many disadvantages [19,20].…”