2M.D. Ulucanlar Eye Training and Research Hospital, Ankara/TURKEY
3M.D. Asistant, Beyoglu Eye Training and Research Hospital, Istanbul/TURKEY
4M.D. Associate Professor, Beyoglu Eye Training and Research Hospital, Istanbul/TURKEY Purpose: To evaluate the temporal relationship between visual outcomes and photoreceptor layer recovery with spectral domain optical coherence tomography (SD-OCT) after pars plana vitrectomy in Stage 4 macular holes.
Materials and Methods: 33 eyes of 33 consecutive patients with stage 4 macular hole were enrolled in this retrospective study. Macular hole (MH) basal diameter, MH height and photoreceptor layer inner segment/outer segment (IS/OS) defect diameter were evaluated via SD-OCT. IS/OS defect diameter values were compared via Bonferroni correction t-test at preoperatively and postoperative month 1, 3 and 6 follow up. IS/OS defect diameter and BCVA were compared via pearson correlation analyses at preoperatively and postoperative month 1, 3 and 6 follow up.
Results: The mean BCVA preoperative and postoperative month 1, 3, and 6 values were 0.86±0.26 (0.5-1.6) logMAR; 1.0±0.32 (0.5-1.6) logMAR; 0.77±0.32 (0.4-1.7) logMAR and 0.72±0.27 (0,4-1,3) logMAR respectively (p=0.024; p=0.034 and p=0.540). The mean photoreceptor IS/OS defect diameter preoperative and postoperative on month 1, 3, and 6 values were 1350.84±339.56 (865.0-2311.0) μ; 874.36±409.63 (174.0-1705.0) μ; 540.30±329.52 (158.0-1406.0) μ and 397.12±294.69 (150.0-1444.0) μ respectively (p=0.000, p=0.000 and p=0.000). Pearson correlation coefficient between IS/OS defect diameter and BCVA were p=0.002 r=0.610 preoperatively, p=0.16 r=0.25 at month 1, p=0.35 r=0.17 at month 3 and p=0.017 r=0.411 at month 6 respectively.
Conclusion: Although photoreceptor layer recovery occurs mostly in first month on SD-OCT after macular hole surgeries; the visual outcome recovery was prolonged up to six month.
Keywords : Inner/outer segment junction, macular hole, pars plana vitrectomy, spectral domain optical coherence tomography