Correlation of Preoperative Optical Coherence Tomography with Pre- and Postoperative Visual Acuity of Macular Hole

Su Jin Kim; Ji Eun Lee; Boo Sup Oum

doi:10.3341/jkos.2008.49.4.583

Journal List > J Korean Ophthalmol Soc > v.49(4) > 1008233

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Kim, Lee, and Oum: Correlation of Preoperative Optical Coherence Tomography with Pre- and Postoperative Visual Acuity of Macular Hole

Original Article

J Korean Ophthalmol Soc 2008;49(4):583-588.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.4.583

Correlation of Preoperative Optical Coherence Tomography with Pre- and Postoperative Visual Acuity of Macular Hole

Su Jin Kim, M.D., Ji Eun Lee, M.D., Ph.D., Boo Sup Oum, M.D., Ph.D.

Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea

Address reprint request to Ji Eun Lee, M.D., Ph.D. Department of Ophthalmology Pusan National University Hospital #1-10 Ami-dong, Seo-gu, Pusan 602-739, Korea Tel: 82-51-240-7326, Fax: 82-51-242-7341, E-mail: jlee@pusan.ac.kr

Received 23 April 2007 Accepted 21 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the correlation between preoperative optical coherence tomography (OCT) parameters and pre- and post-operative visual acuity after macular hole surgery.

Methods

Twenty-five eyes of 24 patients who underwent macular hole surgery with a postoperative follow-up longer than 6 months were studied. On enhanced preoperative horizontal and vertical OCT scans, various parameters including hole diameter, base diameter, total lesion diameter, and hole height were measured. Hole form factor (HFF) and macular hole index (MHI) were calculated. The correlation between the parameters and pre- and post-operative visual acuity, as well as visual acuity change, was analyzed.

Results

There was a significant correlation between hole height and preoperative visual acuity (p=0.018). Better postoperative visual outcome was correlated with a smaller hole diameter, smaller total lesion diameter, and greater hole height (p=0.002, 0.043 and 0.037). HFF and MHI were correlated with visual acuity change (p=0.024 and <0.001)

Conclusions

The correlation between visual acuity and hole height suggests that the height represents the amount of neural tissue in the retina. Relatively greater improvement in visual acuity is expected in eyes with high HFF or MHI even when preoperative visual acuity is low.

Keywords: Macular hole, Optical coherence tomography

References

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Figure 1.

Preoperative parameters of macular hole on optical coherence tomography. HT=height; HD=hole diameter; BD= base diameter; TD=total diameter.

Figure 2.

A case of tall macular hole with high hole form factor (HFF) and macular hole index (MHI). (A) Processed optical coherence tomography (OCT) image shows preoperative parameters. Visual acuity was 0.2. OCT reveals high hole height with extensive cystic changes of the neurosensory retina beyond the extent of the hole base. HFF and MHI were 1.3 and 0.9, respectively. (B) Postoperative 12 months OCT shows normal foveal contour and well‐ organized photoreceptor layer without defect. Visual acuity was 1.0.

Figure 3.

A case of macular hole with low height, high hole form factor (HFF) and macular hole index (MHI). (A) Processed optical coherence tomography (OCT) image demonstrates a small macular hole with low height. The measured preoperative parameters are shown. Visual acuity was 0.08. HFF was 1.0 and MHI was 0.8. (B) Postoperative 6 month OCT shows residual outer retinal defect. Visual acuity was 0.32.

Table 1.

Correlation of macular hole OCT parameter and preoperative best corrected visual acuity (p: Spearman's ran correlation)

Parameters	Average	Preoperative visual acuity		visual acuity Postoperative		change Visual acuity
Parameters	Average	CE^*	p	CE^*	p	CE^*	p
Hole diameter (HD, µm)	512±206	−0.325	0.112	−0.590	0.002	0.174	0.406
Base diameter (BD, µm)	984±389	0.173	0.407	−0.189	0.366	0.336	0.101
Total diameter (TD, µm)	2211±572	−0.184	0.378	−0.409	0.043	0.318	0.121
Hole height (HT, µm)	439±125	0.470	0.018	0.419	0.037	0.047	0.824
BD-HD (µm)	471±336	0.343	0.093	0.082	0.696	0.341	0.095
TD-BD (µm)	1227±411	−0.380	0.061	−0.360	0.077	0.083	0.695
TD-HD (µm)	1699±490	−0.115	0.584	−0.244	0.239	0.225	0.280
HFF^†	6.60±2.79	0.365	0.072	0.621	0.009	0.450	0.024
MHI^‡	0.65±0.35	0.166	0.426	0.704	<0.001	0.714	<0.001

^* CE=correlation efficiency

^† HFF=hole form factor

^‡ MHI=macular hole index.

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