Predictive value of preoperative optical coherence tomography for visual outcome following macular hole surgery: effects
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CLINICAL INVESTIGATION
Predictive value of preoperative optical coherence tomography for visual outcome following macular hole surgery: effects of imaging alignment Wataru Matsumiya • Sentaro Kusuhara Tsuyoshi Shimoyama • Shigeru Honda • Yasutomo Tsukahara • Akira Negi
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Received: 17 August 2012 / Accepted: 8 January 2013 / Published online: 27 February 2013 Ó Japanese Ophthalmological Society 2013
Abstract Purpose To investigate the effects of reproducibility of optical coherence tomography (OCT) measurements and imaging alignment on predictive performance for visual outcome following macular hole (MH) surgery. Methods We retrospectively reviewed 50 eyes that underwent MH surgery. Preoperative cross-sectional images through the center of the MH (on-center image) and through an off-center point (off-center image) were obtained from the OCT data. In each image, the following OCT parameters were either measured or calculated: minimum diameter, base diameter, hole height, temporal and nasal arm length, photoreceptor inner segment/outer segment (IS/OS) defect length, the hole form factor, the macular hole index and the tractional hole index. The IS/ OS defect area was also measured. Results The reproducibility of OCT parameter values was moderate to high, and there was a significant difference in the mean measurement values between the on- and offcenter images. Predictive values varied between sessions and raters, and only the preoperative photoreceptor IS/OS defect length consistently showed significant correlation with postoperative visual outcome. Conclusions Both the reproducibility and imaging alignment might affect the predictive performance of the OCT
Electronic supplementary material The online version of this article (doi:10.1007/s10384-013-0232-1) contains supplementary material, which is available to authorized users. W. Matsumiya S. Kusuhara (&) T. Shimoyama S. Honda Y. Tsukahara A. Negi Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan e-mail: [email protected]
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parameter for postoperative visual outcome following MH surgery. The preoperative photoreceptor IS/OS defect length seems to be the most useful parameter in this regard. Keywords Macular hole Optical coherence tomography Visual acuity Reproducibility Imaging alignment
Introduction Idiopathic full-thickness macular hole (MH) is a major cause of central vision loss. Pars plana vitrectomy (PPV) with peeling of the internal limiting membrane (ILM) is used to achieve anatomical MH closure and subsequent vision recovery [1–4]. Since anatomical success is now considered to be common following MH surgery, it would be ideal to preoperatively inform patients of the possible postoperative visual outcome. For this purpose, several researchers propose predictive factors for visual acuity following MH surgery [5–8]. However, a subset of these factors (e.g., preoperative visual acuity or the duration of symptoms) are based on the subjectiv
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