Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes

Kusuhara, Sentaro; Escaño, M.F.; Fujii, Shigeki; Nakanishi, Yasutaka; Tamura, Yasushi; Nagai, Ayako; Yamamoto, Hiroyuki; Tsukahara, Yasutomo; Negi, Akira

doi:10.1016/j.ajo.2004.04.063

Cited by 204 publications

(224 citation statements)

References 23 publications

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“…Macular thickness and RNFL thickness around the optic disc were measured by OCT (OCT1, Zeiss-Humphrey, Dublin, California), as reported previously. 13,22 In brief, retinal thickness was calculated using OCT retinal mapping software (version 6.1a), which measured thickness of nine divided macular regions (A0-A8) after six scans with 6 mm long under pupillary dilation and expressed as a colour-coded map. RNFL thickness was measured by 3.4-mm-diameter circle scans centred on the optic disc.…”

Section: Methodsmentioning

confidence: 99%

Macular thickness reduction in eyes with unilateral optic atrophy detected with optical coherence tomography

Kusuhara

Nakamura

Nagai-Kusuhara

et al. 2005

Eye

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Aims To assess the changes in macular and peripapillary retinal nerve fibre layer (RNFL) thickness in eyes with unilateral optic atrophy and to evaluate the relationship between retinal thickness and visual function. Methods Enrolled were 22 patients with unilateral optic atrophy. Macular thickness at the divided nine areas and peripapillary RNFL thickness in quadrantic sections were measured by optical coherence tomography. Thickness values in the affected eyes were compared with those in the contralateral unaffected eyes. The correlation of foveal thickness with best-corrected visual acuity (BCVA) was evaluated. The correlation between retinal thickness and the remaining visual field area circumscribed with I-4-e isopter in superior and inferior hemifield was assessed.Results Macular thinning was observed in all areas (Po0.001 in each area) other than the fovea (P ¼ 0.068). Peripapillary RNFL thickness decreased in all quadrantic sections (Po0.001 in each section). The affected to unaffected eye ratio of retinal thickness was more than 0.6 in each area. BCVA did not correlate with foveal thickness (correlation coefficient ¼ 0.094, P ¼ 0.668). Although not statistically significant (P ¼ 0.281, superior hemifield; P ¼ 0.053, inferior hemifield), there was a tendency that eyes with severe visual field loss show more marked retinal thinning. Conclusions Macular thinning with the preserved foveal thickness is a hallmark of eyes with optic atrophy. Together with no correlation between foveal thickness and BCVA, this finding would help in differential diagnosis of macular and optic nerve diseases.

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Section: Methodsmentioning

confidence: 99%

Macular thickness reduction in eyes with unilateral optic atrophy detected with optical coherence tomography

Kusuhara

Nakamura

Nagai-Kusuhara

et al. 2005

Eye

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“…MHI has been proposed to represent the putative tangential and anteroposterior vitreomacular traction thought to be acting on the fovea and causing the macular hole to develop. 12 The association with MHI suggests that holes with greater presumed tractional forces release VMA more readily. By distinction, VMA width that ranged in the study from 102 to 596 μm was not predictive of release.…”

Section: Discussionmentioning

confidence: 99%

Predicting macular hole closure with ocriplasmin based on spectral domain optical coherence tomography

Steel

Parkes

Papastavrou

et al. 2016

Eye

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Purpose To assess the preoperative features of patients with idiopathic macular hole (IMH) and vitreomacular adhesion (VMA) treated with ocriplasmin (OCP) that can predict successful closure. Method Data were prospectively collected on all patients with IMH treated with OCP in three British ophthalmic centres. Several preoperative variables were recorded including the IMH base diameter (BD), minimum linear diameter (MLD), and VMA width measured on spectral domain optical coherence tomography. Several other IMH indices were derived including a 'width factor', defined as the BD minus the MLD in μm. The occurrence of VMA release and hole closure were used as the main outcome measures. Results Thirty-three patients in total with IMH were treated with OCP. Two patients developed rhegmatogenous retinal detachment and were excluded. The mean age of the remaining 31 patients was 71 years, and 71% were female. VMA release occurred in 19 of the 31 (61%) patients and macular hole closure in 11 (35%). Width factor was the most predictive feature for closure on multivariate analysis. The deviance R 2 was 67% (Po0.001). An IMH with a width factor of o60 μm had a 95% certainty of closure, whereas if 4290 μm then there was less than a 5% chance of closure. Neither VMA width nor MLD alone was associated with VMA release or closure. Conclusions Patients with macular holes where the BD was close in size to the MLD had an improved probability of closure than holes with wider base configurations.

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“…21,22 In addition, for determination of preoperative tissue defects, identification of the foveal morphology before hole development is necessary. 7,23,24 However, in most cases the prehole foveal morphology may not be known, although it is well established that foveal morphology between eyes of an individual shows strong symmetry. 25 To assess preoperative morphologic factors that reflect the extent of foveal tissue defects, we compared the preoperative morphologic features and postoperative visual outcomes using OCT. We used the fellow eye's foveal topographic parameters for evaluating individual foveal morphologic variations based on the fact that similar morphologic correlations exist between both eyes.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] Histopathologically, the macular hole size may be comprised of both a centrifugal retraction of the photoreceptors (as Gass had postulated) and foveal tissue defects that include mechanical damage during hole formation or photoreceptor degeneration. [11][12][13][14][15][16] Centrifugal retractions of the photoreceptors may recover immediately after surgery.…”

Section: Introductionmentioning

confidence: 99%

Determination of macular hole size in relation to individual variabilities of fovea morphology

Shin

Chu

Hong

et al. 2015

Eye

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Purpose To determine the preoperative anatomic factors in macular holes and their correlation to hole closure. Methods Forty-six eyes with consecutive unilateral macular hole who had undergone surgery and followed up for at least 6 months were enrolled. Optical coherence tomography images and best-corrected visual acuity (BCVA) within 2 weeks prior to operation and 6 months after surgery were analyzed. The maximal hole dimension, foveal degeneration factors (inner nuclear layer cysts, outer segment (OS) shortening) and the widest foveolar floor size of the fellow eyes were measured. For overcoming preoperative individual variability of foveal morphology, an 'adjusted' hole size parameter (the ratio between the hole size and the fellow eye foveolar floor size) was used based on the fact that both eyes were morphologically symmetrical. Results Mean preoperative BCVA (logMAR) was 1.03 ± 0.43 and the mean postoperative BCVA was 0.50 ± 0.38 at 6 months. Preoperative BCVA is significantly associated with postoperative BCVA (P = 0.0002). The average hole diameter was 448.9 ± 196.8 μm and the average fellow eye foveolar floor size was 461.3 ± 128.4 μm. There was a correlation between hole diameter and the size of the fellow eye foveolar floor (Pearson's coefficient = 0.608, Po0.0001). The adjusted hole size parameter was 0.979 ± 0.358 (0.761-2.336), which was a strong predictor for both anatomic (P = 0.0281) and visual (P = 0.0016) outcome. Conclusion When determining the extent of preoperative hole size, we have to take into consideration the foveal morphologic variations among individuals. Hole size may be related to the original foveal shape, especially in relation to the centrifugal retraction of the foveal tissues.

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Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes

Cited by 204 publications

References 23 publications

Macular thickness reduction in eyes with unilateral optic atrophy detected with optical coherence tomography

Macular thickness reduction in eyes with unilateral optic atrophy detected with optical coherence tomography

Predicting macular hole closure with ocriplasmin based on spectral domain optical coherence tomography

Determination of macular hole size in relation to individual variabilities of fovea morphology

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