RECOVERY OF FOVEAL PHOTORECEPTOR INTEGRITY AFTER VITRECTOMY IN EYES WITH AN IMPENDING MACULAR HOLE WITH VITREOMACULAR TRACTION SYNDROME

Retina. 2016 Aug;36(8):1454-62. doi: 10.1097/IAE.0000000000000934.

Abstract

Purpose: To identify factors associated with the recovery of foveal photoreceptor disruption in eyes with an impending macular hole (MH) with vitreomacular traction syndrome after surgery.

Methods: This study comprised 33 consecutive patients who underwent vitrectomy for Stage 1 impending macular hole with disrupted photoreceptor inner segment/outer segment (IS/OS) layer and were followed up for a minimum of 1 year after surgery. Preoperative optical coherence tomography (OCT) parameters were compared between eyes that achieved complete restoration of the IS/OS layer (Group A) and those that did not (Group B). Postoperative serial changes in best-corrected visual acuity (BCVA) and IS/OS disrupted length were also investigated.

Results: Smooth and symmetric foveolar contour was restored in 29 eyes (87.9%). Complete recovery of IS/OS disruption was observed in 11 of 33 cases (33.3%, Group A). Group A exhibited a larger percentage of foveal pseudocysts (54.5% vs. 13.6%, P = 0.033) and a smaller mean aperture size (102.1 ± 182.1 μm vs. 241.5 ± 163.8 μm, P = 0.031) than Group B. Postoperatively, Group A revealed a significantly better visual outcome than Group Be, which was the same as Group B, but with the four eyes that developed a full-thickness macular hole excluded.

Conclusion: Restoration of the foveal photoreceptor layer was more likely to occur in eyes with a foveal pseudocyst and smaller aperture size.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fovea Centralis
  • Humans
  • Male
  • Middle Aged
  • Recovery of Function / physiology*
  • Retinal Diseases / diagnostic imaging
  • Retinal Diseases / physiopathology
  • Retinal Diseases / surgery*
  • Retinal Perforations / diagnostic imaging
  • Retinal Perforations / physiopathology
  • Retinal Perforations / surgery*
  • Retinal Photoreceptor Cell Inner Segment / physiology*
  • Retinal Photoreceptor Cell Outer Segment / physiology*
  • Retrospective Studies
  • Tissue Adhesions
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Vitrectomy*
  • Vitreous Detachment / diagnostic imaging
  • Vitreous Detachment / physiopathology
  • Vitreous Detachment / surgery*