Correlation Of Foveal Microstructure Changes On SD-OCT And Visual Function After Macular Hole Surgery And The Incidence Of Developing An Idiopathic Full-thickness Macular Hole In Fellow Eyes Of Patients With Unilateral Macular Hole

Objective:1To study morphological and functional recovery after macular holesurgery with pars plana vitrectomy (PPV), indocyanine green assisted, innerlimiting membrane (ILM) peeling,12%C3F8（perfluoropropane）tamponadeusing spectral-domain optical coherence tomography.2To study the changes of vitreoretinal interfaces and the relationship ofthe changes vitreoretinal interfaces and macular hole by determining theincidence of developing an idiopathic full-thickness macular hole in felloweyes using spectral-domain optical coherence tomography.Methods:1The study included40eyes in40consecutive patients with idiopathicfull-thickness macular. holes who underwent treatment at the Second Hospitalof Hebei Medical University in2012.1-2013.12. Preoperative characterizationincluded best corrected visual acuity (BCVA), biomicroscopy, opticalcoherence tomography (OCT) and fundus-photography. Then measured thefoveal retinal thickness、parafoveal retinal thickness、the IS/OS defectdiameter of photoreceptor layer、the morphological changes of foveal retinaland the relationship of morphological and functional recovery in1month、3month、6month after surgery.2The fellow eyes of78patients with fullthickness macular holes wereexamined by optical coherence tomography (OCT) from2008.4-2011.12. Weclassified four vitreomacular relationships: type1, no PVD,27felloweyes;type2, shallow PVD with perifoveal vitreous attachment,23fellow eyes; type3, PVD with foveal vitreous traction,18fellow eyes；type4；ancomplete PVD，10fellow eyes. The incidence of developing an idiopathicfull-thickness macular hole in fellow eyes from1month to24months fromthe initial OCT examination were investigated.And then study the vitreofovealrelationship.Results：1The average foveal retinal thickness were277.30±114.49μm、221.90±75.67μm、222.18±76.30μm in1month、3month、6month aftermacular surgery. Compared foveal retinal thickness after1month with3month,They are significant difference (t=4.906, P <0.05).But foveal retinalthickness are not significantly different in3month and6month after macularsurgery （t=0.042,P=0.967＞0.05）.And the average parafoveal retinalthickness were259.13±81.82μm,214.94±64.58μm,214.84±64.87μm1month、3month、6month after macular surgery.They are not significantlydifferent （P＞0.05） The incidence of DONFL apprearance is52.5%（21/40）.The BCVA related the IS/OS defect diameter in6month aftermacular surgery（R=0.985，P＜0.05）.The U-type closure have the bestpostoperative vision; V-type closure is secondary;W-type closure have theworst postoperative vision. IS/OS and ELM tend to be closed after macularsurgery.The intraretinal cystoid spaces tend to disappeared.2The vitreofoveal relationship changed in19eyes. Type1, no PVD,27fellow eyes，0eyes developed a fullthickness macular hole.Type2, shallowPVD with perifoveal vitreous attachment,23fellow eyes, a subset of3eyesdeveloped a fullthickness macular hole. Type3,PVD with foveal vitreoustraction, a subset of18fellow eyes, a subset of9eyes developed afullthickness macular hole, a subset of4eyes developed an completePVD.Type4；an complete PVD，11fellow eyes,0eyes developed afullthickness macular hole.The incidence of developing an idiopathicfull-thickness macular hole are significantly different. Conclusions:1There was a transient increase in the foveal retinal thickness aftermacular hole surgery.2DONFL is probably caused by a slight edema of inner retinal layercaused by the macular hole surgery.3The postoperative vision are related the IS/OS defect diameter.4The U-type closure have the best postoperative vision; V-type closureis secondary;W-type closure have the worst postoperative vision.5Fellow eyes that have vitreofoveal attachments and perifoveal vitreousdetachment in patients with unilateral idiopathic macular hole are the riskfactors.