Prediction of the Functional Result of Surgery for the Full Thickness of the Macular Hole Based on the Analysis of the Safety of Retinal Tissue

Abstract

Purpose. To study the relationship between baseline optical coherence tomography (OCT) characteristics of preservation of the neurosensory retina and retinal pigment epithelium (RPE) and functional outcome after full thickness macular hole (FTHM) surgery.Materials and methods. Patients with complete postoperative anatomical closure of the FTMH were included in this prospective interventional study. All patients received a standard ophthalmological examination and OCT before surgical treatment. At baseline the area and reflectivity of the neurosensory retina at the edges of the hole was measured on cross-sectional OCT scans. The reflectivity of RPE was evaluated within the hole on structural en face projections of RPE slab. Six months postoperatively, correlation between baseline OCT characteristics and visual outcome was evaluated.Results. Twenty-nine patients (30 eyes, 23 females and 6 males, average age — 66.2 ± 5.2 years) were included in the study. The final best-corrected visual acuity showed a statistically significant correlation with baseline best-corrected visual acuity (r = 0.75, p < 0.001), reflectivity of RPE (r = 0.81, p < 0.001), reflectivity of neurosensory retina (r = –0.88, p < 0.001), and its area (r = 0.41, p = 0.02).Conclusion. OCT-characteristics of retinal tissue preservation, including the area and reflectivity of the neurosensory retina and reflectivity of the RPE within the hole, correlate with functional recovery after FTMH surgery.