Evolution and visual outcomes of outer foveolar lucency after surgery for large idiopathic macular hole
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Evolution and visual outcomes of outer foveolar lucency after surgery for large idiopathic macular hole Biying Qi 1,2 & Yanping Yu 1,2 & Qisheng You 3 & Zengyi Wang 1,2 & Jing Wang 1,2 & Lingzi Liu 1,2
&
Wu Liu 1,2
Received: 24 February 2020 / Revised: 14 June 2020 / Accepted: 19 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To explore the evolution of outer foveolar lucency (OFL) after vitrectomy and the correlation between OFL and visual acuity (VA) outcome in eyes with large idiopathic macular hole (IMH). Methods In this retrospective study, 244 eyes of 233 subjects with large IMH (diameter > 400 μm), who underwent vitrectomy, were included. Preoperative clinical data, postoperative optical coherence tomography (OCT) images, and VA at 1-, 4-, and 10month visits were documented. The prevalence, incidence, and width of OFL and their correlation with postoperative VA were analyzed. Results The prevalence of OFL was 10.4% (24/231) at 1 month and significantly increased to 30.4% (55/181) at 4 months (P < 0.001) and 34.2% (25/73) at 10 months (P < 0.001). The incidence was 26.1% (40/153) and 22.0% (9/41) at 4 and 10 months, respectively. OFL appeared at 1 month while disappeared at 4 or 10 months in 8 eyes (50.0%). The presence of OFL at 1 month was negatively associated with IMH diameter (Nagelkerke R2 = 0.06; P = 0.02). Eyes with OFL at 4 months had better VA at their 4-month visit than eyes without OFL (P = 0.02). Eyes with early-developed OFLs had better VA at 10 months than those with later-developed ones (P = 0.02). Width of OFL was not associated with postoperative VA at any point. Conclusions OFL is not rare in eyes with large IMH after surgery. It can occur gradually and remain during the 10-month followup. The presence of OFL appears to have no negative impact on the postoperative VA and it may represent the remodeling of foveal photoreceptors. Keywords Idiopathic macular hole . Outer foveolar lucency . Prevalence . Incidence . Visual acuity . Optical coherence tomography
Introduction Vitrectomy combined with intravitreal gas tamponade has been verified as effective to close idiopathic macular holes (IMH) [1, 2] and contributes to both anatomical restoration and functional improvement [3]. Optical coherence This article is part of a topical collection on Macular Holes. * Wu Liu [email protected] 1
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
2
Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
3
Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
tomography (OCT) displays the retinal microstructure clearly and has become the primary imaging method for diagnosing IMH and confirming anatomical success after IMH surgery. Outer foveolar lucency (OFL) is commonly found during the restoration of the fovea after MH surgery [4] and has gained a lot of attention by researchers in recent years. T
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