Prognostic factors in vitrectomy for lamellar macular hole assessed by spectral-domain optical coherence tomography

Christopher S. Lee, Hyoung J. Koh, Hyung T. Lim, Kyu S. Lee, Sungchul Lee

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: To evaluate the association between the macular structure on spectral-domain optical coherence tomography (SD-CT) and visual outcome after vitrectomy for lamellar macular hole (LMH). Methods: Best-corrected visual acuity (VA) and SD-OCT images of the macula were assessed before and after surgery in 30 eyes of 30 patients with a LMH. Preoperative VA and SD-OCT features were investigated as predictors of surgical outcome. Results: Mean patient age was 65 years with female predominance (77%). Visual acuity improved in 19 eyes (63%) with an overall mean improvement of 1 Snellen line (from 20/65 to 20/50; p = 0.002) at a mean of 18 months after vitrectomy. Subgroup analysis showed that statistically significant visual benefit was only observed in patients with an intact photoreceptor inner segment/outer segment (IS/OS) junction (p = 0.003), with foveal thickness bigger than 100 μm (p = 0.004) and with initial VA better than 20/100 (p = 0.003). The most efficient model to predict final VA was the combination of preoperative VA and the presence or absence of IS/OS disruption (r2=0.77, p< 0.001). Conclusions: Poor initial VA, the presence of a disrupted IS/OS junction or a thin fovea on preoperative SD-OCT predicted poor vision outcome after LMH surgery.

Original languageEnglish
JournalActa Ophthalmologica
Volume90
Issue number8
DOIs
Publication statusPublished - 2012 Dec 1

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Retinal Perforations
Vitrectomy
Optical Coherence Tomography
Visual Acuity

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

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title = "Prognostic factors in vitrectomy for lamellar macular hole assessed by spectral-domain optical coherence tomography",
abstract = "Purpose: To evaluate the association between the macular structure on spectral-domain optical coherence tomography (SD-CT) and visual outcome after vitrectomy for lamellar macular hole (LMH). Methods: Best-corrected visual acuity (VA) and SD-OCT images of the macula were assessed before and after surgery in 30 eyes of 30 patients with a LMH. Preoperative VA and SD-OCT features were investigated as predictors of surgical outcome. Results: Mean patient age was 65 years with female predominance (77{\%}). Visual acuity improved in 19 eyes (63{\%}) with an overall mean improvement of 1 Snellen line (from 20/65 to 20/50; p = 0.002) at a mean of 18 months after vitrectomy. Subgroup analysis showed that statistically significant visual benefit was only observed in patients with an intact photoreceptor inner segment/outer segment (IS/OS) junction (p = 0.003), with foveal thickness bigger than 100 μm (p = 0.004) and with initial VA better than 20/100 (p = 0.003). The most efficient model to predict final VA was the combination of preoperative VA and the presence or absence of IS/OS disruption (r2=0.77, p< 0.001). Conclusions: Poor initial VA, the presence of a disrupted IS/OS junction or a thin fovea on preoperative SD-OCT predicted poor vision outcome after LMH surgery.",
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Prognostic factors in vitrectomy for lamellar macular hole assessed by spectral-domain optical coherence tomography. / Lee, Christopher S.; Koh, Hyoung J.; Lim, Hyung T.; Lee, Kyu S.; Lee, Sungchul.

In: Acta Ophthalmologica, Vol. 90, No. 8, 01.12.2012.

Research output: Contribution to journalArticle

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AB - Purpose: To evaluate the association between the macular structure on spectral-domain optical coherence tomography (SD-CT) and visual outcome after vitrectomy for lamellar macular hole (LMH). Methods: Best-corrected visual acuity (VA) and SD-OCT images of the macula were assessed before and after surgery in 30 eyes of 30 patients with a LMH. Preoperative VA and SD-OCT features were investigated as predictors of surgical outcome. Results: Mean patient age was 65 years with female predominance (77%). Visual acuity improved in 19 eyes (63%) with an overall mean improvement of 1 Snellen line (from 20/65 to 20/50; p = 0.002) at a mean of 18 months after vitrectomy. Subgroup analysis showed that statistically significant visual benefit was only observed in patients with an intact photoreceptor inner segment/outer segment (IS/OS) junction (p = 0.003), with foveal thickness bigger than 100 μm (p = 0.004) and with initial VA better than 20/100 (p = 0.003). The most efficient model to predict final VA was the combination of preoperative VA and the presence or absence of IS/OS disruption (r2=0.77, p< 0.001). Conclusions: Poor initial VA, the presence of a disrupted IS/OS junction or a thin fovea on preoperative SD-OCT predicted poor vision outcome after LMH surgery.

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