Recovery Course of Macular Structure after Macular Hole Surgery: Using a Spectral Domain Optical Coherence Tomography Image

Purpose: To analyze the recovery course of foveal microstructures and evaluate the important structures for visual improvement after vitrectomy for full thickness macular hole (MH) using optical coherence tomography (OCT). Methods: We retrospectively reviewed the medical records of 34 cases with idiopathic macular hole. We investigated the healing process of foveal microstructures and visual acuity pre- and post-operatively at 1, 3, 6, 12 months after surgery. We evaluated the integrity of four factors by OCT image: existence of MH (Hole, H-1,H-3,H-6,H-12), recovery of outer nuclear layer (ONL, O-1,O-3,O-6,O-12), recovery of external limiting membrane (ELM, E-1,E-3,E-6,E-12), and recovery of inner segment-outer segment (IS/OS) line of the photoreceptor (Photoreceptor, P-1,P-3,P-6,P-12). We compared the recovery course and visual acuity of the four groups based on postoperative 12 months. Results: The mean observed period was 1.85 +/- 2.59 months at recovery of ONL, 3.78 +/- 3.83 months at recovery of ONL and ELM, and 7.40 +/- 3.56 months at recovery of ONL, ELM and IS/OS line. At postoperative 12 months, the best corrected visual acuity (BCVA) of Groups E and P were better than that of Groups H and O (p < 0.05). Except for group H, all groups had improved BCVA at postoperative 12 months compared to preoperative BCVA (p < 0.05). Conclusions: Recovery sequences of foveal microstructures were ONL, ELM and IS/OS line after vitrectomy for idiopathic MH. The most important structures for visual acuity were restorations of both ELM and IS/OS line.