A new approach in predicting the functional outcome in the treatment of patients with a full-thickness macular hole

Abstract

Aim. To study the relationship of the characteristics of the preservation of the sensorineural retina and retinal pigment epithelium (RPE) obtained by optical coherence tomography (OCT) with functional recovery in the surgical treatment of full thickness macular hole (FTHM). Materials and methods. This study included 89 patients (95 eyes) with an average age of 67.2 ± 9.6 years, having complete postoperative anatomical closure of the FTMH. All patients underwent standard ophthalmological examination and OCT before surgical treatment. On cross-sectional and en face images, the area and reflexivity of the neurosensory retina tissue at the edges of the gap and the reflexivity of the RPE in the projection of the gap were evaluated. 12 months after surgical treatment, the correlation between the initial indicators of retinal tissue preservation and functional recovery was evaluated. Results. 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 = 0.91, p < 0.001), reflectivity of neurosensory retina (r = – 0.85, p < 0.001), and its area (r = 0.83, p < 0.001). Conclusion. Indicators of retinal tissue preservation, such as the area and reflexivity of the neurosensory retina tissue and the reflexivity of the RPE, correlate with functional recovery after FTMH surgery. Keywords: full-thickness macular hole, optical coherence tomography, optical coherence tomography angiography