Relationship Between Hole Configuration And Predicted Visual Acuity In Eyes With Idiopathic Macular Hole

Objectives: Got the optical coherence tomagraphy(OCT) images of the idiopathic macular hole (IMH, Idiopathic macular hole) patients post the operation of vitrectomy and internal limiting membrane peeling (ILMP) surgery, analyzed the relationship between the macular hole configuration and the postoperative best corrected visual acuity.Methods: Selected 32 consecutive patients of IMH (7 male, 25 female), which were done the operation of PPV and ILMP, were examined with OCT before and after the operation. The minimum diameter, the base diameter, the hole high the macular retinal thickness before the operation all being measured by OCT, and the Macular hole index (MHI) was was caculated, which were all correlated BCVA post operation. All statistics was analyzed by the SPSS13.0.Results: (1)The relationship between the postop BCVA and macular hole configuration parameter before the operation : The negative correlation was observed between the post operative BCVA and the minimum diameter ( r₁=-0.524, P=0.000 < 0.01 ) and the base diameter(r₂=-0.610,P=0.000<0.01).(2) The relationship between the MHI and the configuration of the macular hole before the operation :The significant correlation was observed between the MHI and the minimum diameter (r=-0.417,p=0.018 <0.05) and the base diameter (r=-0.782, p=0.000<0.01).(3)The positive correlation was observed between the postop BCVA and the MHI (r=0.457, P=0.006 < 0.01) ; Postop BCVA in the MHI≥0.5 group was much better than that in the MHI < 0.5 (Mann-Whitney Test) (U=30.0,W=135, p=0.000<0.01)(4) By OCT result, Anatomic success was achieved in 27 (84.38%) of 32 patients.The postop BCVA was much better than that before the operation (Wilcoxon Signed Ranks Test) (Z=-4.203,p=0.000<0.01) .Conclusions: 1. The macular hole configuration parameter, such as the minimum diameter and the base diameter which was measured by OCT is valuable for predicting the post operative BCVA.2. The MHI was easily caculated and correlated well with postop BCVA, we can used it as clinical index for visual acuity predicting instead of macular hole diameter.3. The PPV combined with IMLP surgery can effectively treated the IMH according on the OCT result.