Ophthalmology · 2010
Foveal microstructure and visual acuity in surgically closed macular holes: spectral-domain optical coherence tomographic analysis.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Wakabayashi Taku, Fujiwara Maiko, Sakaguchi Hirokazu, Kusaka Shunji, Oshima Yusuke
Аннотация
PURPOSE: To evaluate reconstructive changes in foveal microstructures and identify a correlation with visual outcomes in eyes with surgically closed macular holes (MHs).
DESIGN: Retrospective, consecutive, observational case series.
PARTICIPANTS: Forty eyes (40 patients) with surgically closed MHs.
METHODS: Spectral-domain optical coherence tomography (SD-OCT) was performed to assess the foveal microstructural changes 3 and 12 months postoperatively. The correlation between the postoperative best-corrected visual acuity (BCVA) and the integrity of the foveal photoreceptor layer was evaluated.
MAIN OUTCOME MEASURES: The integrity of the back-reflection lines from the photoreceptor inner segment (IS) and outer segment (OS) junction and the external limiting membrane (ELM) on SD-OCT images and the BCVA measured on the same day.
RESULTS: The integrity of the foveal photoreceptor layer was the only postoperative SD-OCT finding significantly associated with the 3-month BCVA (r=0.483; P=0.002). The eyes were categorized into 3 groups according to restoration of the IS/OS junction and ELM signals: 6 eyes (15%) in group A with complete restoration of the IS/OS junction and the ELM; 26 eyes (65%) in group B with a disrupted IS/OS junction and intact ELM; and 8 eyes (20%) in group C with disruption or loss of the IS/OS junction and the ELM. Although the baseline BCVA did not differ significantly (P=0.137) among groups, the mean 3-month BCVA values in groups A and B, both with reconstructed ELM with or without a restored photoreceptor IS/OS, were significantly better than in group C (P<0.05); the difference between groups A and B was not significant (P>0.05). Groups A (P=0.029) and B (P<0.001) had significant visual improvement at 12 months; group C did not have marked visual recovery. Fourteen eyes (54%) in group B had subsequent realignment of the foveal photoreceptor IS/OS; no eyes in group C had a restored IS/OS at 12 months. The presence of the ELM at 3 months is a critical structural feature significantly correlated with the BCVA at 12 months (r=0.832, P<0.001).
CONCLUSIONS: Reconstruction of the foveal ELM in the early postoperative period helps predict subsequent restoration of the foveal photoreceptor layer and the potential for better visual outcomes.
DESIGN: Retrospective, consecutive, observational case series.
PARTICIPANTS: Forty eyes (40 patients) with surgically closed MHs.
METHODS: Spectral-domain optical coherence tomography (SD-OCT) was performed to assess the foveal microstructural changes 3 and 12 months postoperatively. The correlation between the postoperative best-corrected visual acuity (BCVA) and the integrity of the foveal photoreceptor layer was evaluated.
MAIN OUTCOME MEASURES: The integrity of the back-reflection lines from the photoreceptor inner segment (IS) and outer segment (OS) junction and the external limiting membrane (ELM) on SD-OCT images and the BCVA measured on the same day.
RESULTS: The integrity of the foveal photoreceptor layer was the only postoperative SD-OCT finding significantly associated with the 3-month BCVA (r=0.483; P=0.002). The eyes were categorized into 3 groups according to restoration of the IS/OS junction and ELM signals: 6 eyes (15%) in group A with complete restoration of the IS/OS junction and the ELM; 26 eyes (65%) in group B with a disrupted IS/OS junction and intact ELM; and 8 eyes (20%) in group C with disruption or loss of the IS/OS junction and the ELM. Although the baseline BCVA did not differ significantly (P=0.137) among groups, the mean 3-month BCVA values in groups A and B, both with reconstructed ELM with or without a restored photoreceptor IS/OS, were significantly better than in group C (P<0.05); the difference between groups A and B was not significant (P>0.05). Groups A (P=0.029) and B (P<0.001) had significant visual improvement at 12 months; group C did not have marked visual recovery. Fourteen eyes (54%) in group B had subsequent realignment of the foveal photoreceptor IS/OS; no eyes in group C had a restored IS/OS at 12 months. The presence of the ELM at 3 months is a critical structural feature significantly correlated with the BCVA at 12 months (r=0.832, P<0.001).
CONCLUSIONS: Reconstruction of the foveal ELM in the early postoperative period helps predict subsequent restoration of the foveal photoreceptor layer and the potential for better visual outcomes.