Prognostic Role of Optical Coherence Tomography in Outcome of Idiopathic full thickness Macular Hole Surgery

  • Uzma Haseeb AlIbrahim eye hospital karachi
  • Muhammad Haseeb AL AIN Institute of eye diseases
  • Aziz ur Rehman AlIbrahim eye hospital karachi
  • Tauseef Mehmood AlIbrahim eye hospital karachi
Keywords: OCT, Macular Hole, Hole Forming Factor, Macular Hole Index

Abstract

Abstract

Purpose: To assess the prognostic value of Optical Coherence Tomography indices preoperatively in outcome of idiopathic full thickness macular hole surgery.

Material & Methods:  A Quasi experimental study was carried out at Al Ibrahim eye hospital, Karachi from June 2019 to Feb 2020. Patients between 50 to 70 years of age, including both genders with full thickness idiopathic macular hole on Optical Coherence Tomography (OCT) were included while patients with secondary causes of macular hole like trauma, myopia, detachment of retina with macular hole, macular hole with other causes of poor vision like corneal scaring, Age related macular degeneration and diabetic retinopathy were excluded. OCT measurements are basal diameter, height of macular hole, right and left arm length and derived indices are macular hole index (MHI) and hole form factor (HFF).

Results: A total 33 patients including 23 (69.6%) male and 10(30.3%) females of idiopathic full thickness macular hole were taken. Patients  mean age was 55.25±6.9. Among 33 patients, MHI (>0.5) was found in 21(63.6%) patients while 12 (36.3%) patients had MHI (< 0.5). In 25 patients HFF calculation was possible. 17(68%) patients had HFF (>0.9) while 8  (32%) patients had HFF (< 0.9). Anatomical and visual outcomes were assessed at 1st and 3rd month follow-up. Of 21 patients for MHI >0.5, vision improved (i.e. ≥ 6/18) in 15 (71.4%). Similarly, out of 17 patients for HFF > 0.9, 13 (76.47%) patients had improved vision post-operatively.

Conclusion: Optical coherence tomography indices can be helpful to predict surgical outcomes of idiopathic full thickness macular hole surgery.

References

1. Venkatesh R, Mohan A, Sinha S, Aseem A, Yadav NK. Newer indices for predicting macular hole closure in idiopathic macular holes: A retrospective, comparative study. Indian J Ophthalmol. 2019;67(11):1857-62.
2. Majumdar S, Triparty K. Hyperopia. StatPearls [Internet]. 2021.
3. Khaqan HA, Lubna, Jameel F, Muhammad. Visual Outcomes of Macular Hole Surgery. J Coll Physicians Surg Pak. 2016;26(10):839-42.
4. Oh KT. Medscape [Internet]. Drugs and diseases. Ophthalmology. Douglas R Lazzaro; [updated 2020 Jan 2; cited 2021 March 10]. Available from: https://emedicine.medscape.com/article/1224320-overview
5. Ahmad N, Shah SR, Ch QL, Tahir MY, Mahju TM, Ahmed CN. et. al. Out Come of Macular Hole Surgery at Mayo Hospital, Lahore. Pak J Ophthalmol. 2012;28(2).
6. Zhao PP, Wang S, Liu N, Shu ZM, Zhao JS. A Review of Surgical Outcomes and Advances for Macular Holes. J Ophthalmol. 2018.
7. Hu Y, Xiao Y, Quan W, Zhang B, Wu Y, Wu Q. et.al. A multi-center study of prediction of macular hole status after vitrectomy and internal limiting membrane peeling by a deep learning model. Ann Transl Med. 2021;9(1):51.
8. Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991;109(5):654-9.
9. Feroz L, Rizvi SF, Naz S, Khan MTH. Pre-operative predicting factor in visual outcome after macular hole surgery. Pak J Med Sci. 2020;36(5):1053.
10. Ip MS, Baker BJ, Duker JS, Reichel E, Baumal CR, Gangnon R. et.al. Anatomical outcomes of surgery for idiopathic macular hole as determined by optical coherence tomography. Archives of Ophthalmology. 2002 Jan 1;120(1):29-35.
11. Kusuhara S, Teraoka Escaño MF, Fujii S, Nakanishi Y, Tamura Y, Nagai A. et.al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol. 2004;138(5):709-16.
12. Hasan SU, Rizvi SF, Mahmood SA, Zafar S, Hasan T. Anatomical outcome following indocyanine green assisted internal limiting membrane peeling for stage 3 and 4 macular hole surgery. J Coll Physicians Surg Pak. 2017;27(8):486-9.
13. Unsal E, Cubuk MO, Ciftci F. Preoperative prognostic factors for macular hole surgery: Which is better? Oman J Ophthalmol. 2019 ;12(1):20-24.
14. Kusuhara S, Teraoka Escaño MF, Fujii S, Nakanishi Y, Tamura Y, Nagai A. et.al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol. 2004;138(5):709-16.
15. Tinwala SI. Optical Coherence Tomography: Essential Tool in Macular Hole Management. OCT: Applications in Ophthalmology. Michele Lanza;2018.
16. Geng XY, Wu HQ, Jiang JH, Jiang K, Zhu J, Xu Y, et.al. Area and volume ratios for prediction of visual outcome in idiopathic macular hole. Int J Ophthalmol. 2017;10(8):1255-60.
17. Ruiz-Moreno JM, Staicu C, Piñero DP, Montero J, Lugo F, Amat P. Optical coherence tomography predictive factors for macular hole surgery outcome. Br J Ophthalmol. 2008;92(5):640-4.
18. Haritoglou C, Neubauer AS, Reiniger IW, Priglinger SG, Gass CA, Kampik A. Long-term functional outcome of macular hole surgery correlated to optical coherence tomography measurements. Clin Exp Ophthalmol. 2007 Apr;35(3):208-13.
19. Lai CC. Internal Limiting Membrane: Making the Decision to Peel. Retina today. 2015:35-37
20. Rani D, Aggarwal P. Surgical Options in Management of Macular Hole. DJO. 2021;31(3):18-22.
21. Villate N, Lee JE, Venkatraman A, Smiddy WE. Photoreceptor layer features in eyes with closed macular holes: optical coherence tomography findings and correlation with visual outcomes. Am J Ophthalmol. 2005;139(2):280-9.
22. Wakely L, Rahman R, Stephenson J. A comparison of several methods of macular hole measurement using optical coherence tomography, and their value in predicting anatomical and visual outcomes. Br J Ophthalmol. 2012;96(7):1003-7.
23. Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Schuman JS, et.al. Optical coherence tomography of macular holes. Ophthalmology. 1995 May;102(5):748-56.
24. Ullrich S, Haritoglou C, Gass C, Schaumberger M, Ulbig MW, Kampik A. Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol. 2002;86(4):390-3.
25. Tayyab H, Siddiqui R, Jahangir S, Hashmi S. Optical Coherence Tomography based indices in predicting functional outcome of macular hole surgery: A retrospective chart review. Pak J Med Sci. 2021;37(5):1504-08.
Published
2022-03-31
How to Cite
1.
Haseeb U, Haseeb M, Rehman A, Mehmood T. Prognostic Role of Optical Coherence Tomography in Outcome of Idiopathic full thickness Macular Hole Surgery. JRMC [Internet]. 31Mar.2022 [cited 27May2022];26(1):117-21. Available from: https://journalrmc.com/index.php/JRMC/article/view/1818