Prognostic Value of Oct in Macular Hole Surgery

Abstract

To pre-operatively stage macular hole based on OCT and to calculate Macular Hole Index and Hole Form Factor. To determine post-operative visual outcome and macular hole closure. METHODS: Prospectively reviewed 25 eyes of Macular Hole. All the patients with complain of diminution of vision and defective central field of vision were examined. Before and after surgery complete clinical examination and OCT was performed which included macular hole diameter at the level of RPE(base diameter) and at the minimal extent of hole(minimum diameter),Vertical Height, Horizontal Diameter, Left Arm Length, Right Arm Length ,Macular Hole Index and Hole Form Factor. 21 Gauge Pars Plana Vitrectomy with ILM peeling was performed in all patients. RESULTS: 25 eyes of 25 consecutive patients were studied. There were 14 (56%) men and 11(44%) women, with an average age of 60 years (50 to 75 years, median 60 years) Mean follow up time was 1 month. At 3 months 6 of 25 patients (24%) attained a visual acuity greater than or equal to 6/36. Patients of macular hole were found to be most in idiopathic (18/25, 72%) in nature .On OCT most of the macular hole in stage 3 and stage 4 were associated with subretinal fluid, epiretinal membrane.12% patients had Grade II,40% had Grade III, 48% had Grade IV Macular Hole.Negative co-relation was found between both the base and minimum diameterand post-operative visual acuity. Post-operative outcome is better in pateints with MHI >0.5, HFF>0.9.