Predicting results of idiopathic macular hole surgery

    There are some works on predicting the functional results in patients with idiopathic macular holes (IMH).

    Purpose. To estimate the role of microperimetry and optical coherence tomography in predicting the results of the idiopathic macular holes surgical treatment.

    Material and methods. A retrospective analysis of the treatment results of 51 patients with IMH (51 eyes) aged from 52 to 77 years was carried out. Patients were classified into 3 groups depending on the IMH size: small (up to 250 μm) – 15 patients (15 eyes); medium (250-400 μm) – 16 patients (16 eyes) and large (over 40 μm) – 20 patients (20 eyes). The follow-up period was 6 months.

    Results. To determine the predicted visual acuity, we used a formula for the dependence of BCVA post-op on the retinal photosensitivity and the minimum IMH diameter pre-op: Z = 0,1227 – 0,0002 × X + 0,0099 × Y, where Z is the BCVA post-op, X is the minimum IMH diameter pre-op (μm), Y is the retinal photosensitivity pre-op (dB). After surgical treatment: 1st patients’ group had a significant improvement of BCVA by 0.28 ± 0.06, retinal photosensitivity – by 5.1 ± 1.3 dB, predicted BCVA was 0.38 ± 0.041; in the 2nd group BCVA improved by 0.17 ± 0.06, retinal photosensitivity – by 4.8 ± 2.6 dB, predicted BCVA was 0.23 ± 0.047; in the 3rd group BCVA improved by 0.07 ± 0.07, retinal photosensitivity by 2.5 ± 1.2 dB, predicted BCVA was 0.17 ± 0.06.

    Conclusion. The formula derived on the basis of these examinations can be successfully applied to predict functional outcome before surgical treatment.

    Keywords: idiopathic macular hole, microperimetry, vitrectomy, optical coherence tomography.