Long‐term functional outcome of macular hole surgery correlated to optical coherence tomography measurements

Abstract

Objective:  Evaluation of long‐term functional outcome after macular hole surgery and its correlation with postoperative optical coherence tomography (OCT).Methods:  Before and after surgery a complete clinical examination and OCT were performed in 38 patients. Best corrected postoperative visual acuity (VA) was correlated to the following OCT parameters: preoperative base and minimum diameter of the hole, hole height, hole form factor, retinal thickness and nerve‐fibre layer measurements postoperatively, postoperative foveal contour, appearance of retinal pigment epithelium layer and photoreceptor layer.Results:  Over a mean follow up of 67 months, VA improved significantly (P = 0.01). Retinal thickness and retinal thickness and nerve‐fibre layer measurements of the operated eye did not differ from fellow eye. A negative correlation was seen between final VA and preoperative base diameter of the hole (r = −0.41, P = 0.02) and hole height (r = −0.45, P = 0.01). The correlation between hole form factor values and final VA (r = 0.36, P = 0.04) was weak. Appearance of the photoreceptor band was the only OCT parameter significantly correlating with final VA (r = −0.42, P = 0.01) and explaining the observed increase (r = −0.32, P = 0.05) in VA.Conclusion:  Appearance of the photoreceptor layer on postoperative OCT correlates to functional outcome and may help to explain cases of unsatisfactory postoperative VA despite successful hole closure.