Skip to main content

Advertisement

SpringerLink
Log in

Correlation between foveal structure and visual outcome following macular hole surgery: a spectral optical coherence tomography study

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this paper is to evaluate the retinal structure after macular hole surgery and to study the correlation of structural findings with final functional outcomes, using high-speed, high-resolution spectral optical coherence tomography (SOCT).

Methods

Sixty-eight eyes of 60 patients with full-thickness macular holes were included in the study. All patients underwent pars plana vitrectomy with trypan blue staining and internal limiting membrane (ILM) peeling. Patients were evaluated by SOCT, with 6 μm axial and 12–18 μm transverse resolution and three-dimensional images of the retina.

Results

There were four different types of macular hole closure: U-shape, V-shape, irregular and flat/open. The following retinal abnormalities were observed in postoperative scans: photoreceptor irregularities, lack of photoreceptors (photoreceptor defect), cysts in outer retinal layers, nerve fiber layer defects, lesion of all retinal layers, and RPE defects. It was possible to evaluate photoreceptor defects on a three-dimensional image. Retinal thickness in the fovea was also measured.

Conclusions

Because of excellent resolution, SOCT is capable of visualization of retinal defects after macular hole surgery. Three-dimensional examination is adequate for evaluation of photoreceptor defects. Good postoperative visual acuity is correlated with U-shape closure, normal foveal thickness and absence of photoreceptor layer defects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Benson WE, Cruickshanks KC, Fong DS, Williams GA, Bloome MA, Frambach DA, Kreiger AE, Murphy RP (2001) Surgical management of macular holes: a report by the American Academy of Ophthalmology. Ophthalmology 108:1328–1335

    Article  PubMed  CAS  Google Scholar 

  2. Brooks HL Jr (2000) Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 107:1939–1949

    Article  PubMed  Google Scholar 

  3. Cheng L, Azen SP, El-Bradey MH, Toyoguchi M, Chaidhawangul S, Rivero ME, Scholz BM, Freeman WR (2002) Vitrectomy for Macular Hole Study Group. Effects of preoperative and postoperative epiretinal membranes on macular hole closure and visual restoration. Ophthalmology 109:1514–1520

    Article  PubMed  Google Scholar 

  4. Feron EJ, Veckeneer M, Parys-Van Ginderdeuren R, Van Lommel A, Melles GR, Stalmans P (2002) Trypan blue staining of epiretinal membranes in proliferative vitreoretinopathy. Arch Ophthalmol 120:141–144

    PubMed  Google Scholar 

  5. Gass JD (1988) Idiopathic senile macular hole. Its early stages and pathogenesis. Arch Ophthalmol 106:629–639

    PubMed  CAS  Google Scholar 

  6. Guyer DR, Green WR, de Bustros S, Fine SL (1990) Histopathologic features of idiopathic macular holes and cysts. Ophthalmology 97:1045–1051

    PubMed  CAS  Google Scholar 

  7. Imai M, Iijima H, Gotoh T, Tsukahara S (1999) Optical coherence tomography of successfully repaired idiopathic macular holes. Am J Ophthalmol 128:621–627

    Article  PubMed  CAS  Google Scholar 

  8. Kang SW, Ahn K, Ham DI (2003) Types of macular hole closure and their clinical implications. Br J Ophthalmol 87:1015–1019

    Article  PubMed  CAS  Google Scholar 

  9. Kelly NE, Wendel RE (1991) Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol 109:654–659

    PubMed  CAS  Google Scholar 

  10. Kitaya N, Hikichi T, Kagokawa H, Takamiya A, Takahashi A, Yoshida A (2004) Irregularity of photoreceptor layer after successful macular hole surgery prevents visual acuity improvement. Am J Ophthalmol 138:308–310

    Article  PubMed  Google Scholar 

  11. Ko TH, Witki AJ, Fujimoto JG, Chan A, Rogers AH, Baumal CR, Schuman JS, Drexler W, Reichel E, Duker JS (2006) Ultrahigh-resolution optical coherence tomography of surgically closed macular holes. Arch Ophthalmol 124:827–836

    Article  PubMed  Google Scholar 

  12. Li K, Wong D, Hiscott P, Stanga P, Groenewald C, McGalliard J (2003) Trypan blue staining of internal limiting membrane and epiretinal membrane during vitrectomy: visual results and histopathological finding. Br J Ophthalmol 87:216–219

    Article  PubMed  CAS  Google Scholar 

  13. Mester U, Becker M (1998) Prognostic factors in surgery of macular holes. Ophthalmologe 95:158–162

    Article  PubMed  CAS  Google Scholar 

  14. Michalewska Z, Michalewski J, Nawrocki J (2007) Diagnosis and evaluation of macular hole with the HRT 2 retina module. Ophthalmologe 104:881–888

    Article  PubMed  CAS  Google Scholar 

  15. Pel-Przybyszewska E, Szkudlarek E, Szkudlarek A, Nawrocki J (2004) The estimation of macular hole surgery results. Klin Oczna 106:321–324

    PubMed  Google Scholar 

  16. Reiniger IW,Gass CA, Schaumberger M, Kampik A, Haritoglou C (2006) Long-term functional results after macular hole surgery. Results of a prospective study. Ophthalmologe 103:501–505

    Article  PubMed  Google Scholar 

  17. Scott IU, Moraczewski AL, Smiddy WE, Flynn HW Jr, Feuer WJ (2003) Long-term anatomic and visual acuity outcomes after initial anatomic success with macular hole surgery. Am J Ophthalmol 135:633–640

    Article  PubMed  Google Scholar 

  18. Srinivasan VJ, Wojtkowski M, Witkin AJ, Duker JS, Ko TH, Carvalho M, Schuman JS, Kowalczyk A, Fujimoto JG (2006) High-definition and 3-dimensional imaging of macular pathologies with high-speed ultrahigh-resolution optical coherence tomography. Ophthalmology 113:2054–2065

    Article  PubMed  Google Scholar 

  19. Tornambe PE, Poliner LS, Grote K (1997) Macular hole surgery without face-down positioning: a pilot study. Retina 17:179–185

    PubMed  CAS  Google Scholar 

  20. Uemoto R, Yamamoto S, Takeuchi S (2004) Epimacular proliferative response following internal limiting membrane peeling for idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol 242:177–180

    Article  PubMed  Google Scholar 

  21. Ulrich S, Hartiglou C, Gass C, Schaumberger M, Ulbig MW, Kampik A (2002) Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol 86:390–393

    Article  Google Scholar 

  22. Veckeneer M, van Overdam K, Monzer J, Kobuch K, van Marle W, Spekreijse H, van Meurs J (2001) Ocular toxicity study of trypan blue applied in the vitreous cavity of rabbit eyes. Graefes Arch Clin Exp Ophthalmol 239:698–704

    Article  PubMed  CAS  Google Scholar 

  23. Villate N, Lee JE, Venkatraman A, Smiddy WE (2005) Photoreceptor layer features in eye with closed macular holes: optical coherence tomography findings and correlation with visual outcomes. Am J Ophthalmol 139:280–289

    Article  PubMed  Google Scholar 

  24. Wojtkowski M, Leitgeb R, Kowalczyk A, Bajraszewski T, Fercher AF (2002) In vivo human retinal imaging by Fourier domain optical coherence tomography. J Biomed Optics 7:457–463

    Article  Google Scholar 

  25. Wojtkowski M, Bajraszewski T, Gorczynska I, Targowski P, Kowalczyk A, Wasilewski W, Radzewicz C (2004) Ophthalmic imaging by spectral optical coherence tomography. Am J Ophthalmol 138:412–419

    Article  PubMed  Google Scholar 

  26. Wojtkowski M, Srinivasan VJ, Fujimoto JG, Ko T, Schuman JS, Kowalczyk A, Duker JS (2005) Three dimensional retinal imaging with high-speed ultrahigh-resolution optical coherence tomography. Ophthalmology 112:1734–1746

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinika Okulistyczna “Jasne Blonia”, ul. Rojna 90, Lodz, 91-162, Poland

    Zofia Michalewska, Janusz Michalewski, Slawomir Cisiecki & Jerzy Nawrocki

  2. Yale University School of Medicine, New Haven, CT, USA

    Ron Adelman

Authors
  1. Zofia Michalewska
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janusz Michalewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Slawomir Cisiecki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ron Adelman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jerzy Nawrocki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zofia Michalewska.

Additional information

The contents of this manuscript were presented at the annual meeting 2007 of the German Ophthalmological Society (DOG) and at the annual meeting 2007 of the American Society of Retina Specialists (ASRS).

The authors have no financial interest in this study.

The authors have full control of all primary data, and they agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review their data upon request.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Michalewska, Z., Michalewski, J., Cisiecki, S. et al. Correlation between foveal structure and visual outcome following macular hole surgery: a spectral optical coherence tomography study. Graefes Arch Clin Exp Ophthalmol 246, 823–830 (2008). https://doi.org/10.1007/s00417-007-0764-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-007-0764-5

Keywords

Search

Navigation