| Objective: The goal of this study was to find the correlation between idiopathic macular hole shape parameters by optical coherence tomography for precise measurements and visual outcome, and to make clear the morphological parameters of influence prognosis of vision outcome, looking for the objective index that predicting visual outcome for following surgery for idiopathic macular holes, and verified the result of the predecessors’ research.Methods: This is a restrospective study. Collected the clinical data(including outpatient records, OCT examination results, hospitalization pathography, o peration records) of 28 cases(29 eyes) of patients that was diagnosed with idiopathic macular hole and undergoing a standard three-channel vitrectomy with internal limiting membrane and postoperative follow-up of more than 1 months from June 2011 to October 2014 in sheng yang he eye hospital. Of the 29 patients,4 cases(4 eyes) of men, 24 cases(25 eyes) of women, the average age 63-year old(range 52-71 years), records of preoperative and postoperative best corrected visual acuity. the height(H), minimum liner diameter(MLD), basal diameter(BD), left right arm length(M, N), the diameter of the lumen of the retina around macular hole(a1, a2, b1, b2), the retinal thickness values and the length of the value through the lumen(A, a, B, b), number of basal angle(∠A, ∠B)were by OCT. And calculation out macular hole index(MHI=H/BD), and macular hole tractional index(THI=H/MLD), and diameter hole index(DHI=MLD/BD), and macular hole form factor(HHF=(M+N)/BD), and average diameter of the lumen of the retina around macular hole((A1+A2+B1+B2)/2), and average retinal edema degrees((a*A+b*B)/2), average number of basal angle((∠A+∠B)/2), By SPSS19.0 Statistical software, to be correlation analysis between patient age, duration of symptoms, the parameters of measured, the calculated value and postoperative best corrected Visual acuity, and validation to MHI=0.5 as a prognostic marker for predicting Visual acuity.Results: The average hole height was 410.793 ± 58.507 μ m, average minimum diameter of hole was 502.034 ± 179.666 μ m, mean basal diameter was 963.431 ±424.915μm, average hole form factor was 0.686 ± 0.178,average macular hole index was 0.475 ± 0.160, average macular traction index was 0.992±0.370, average macular diameter index was 0.534±0.110, average lumen diameter was 701.276 ± 207.400, mean retinal edema degree was 69802.707 ± 36777.202, average number of basal angles was 50.750±6.288, the minimum diameter and basal diameter was negatively correlated with postoperative best corrected Visual acuity(r=-0.400, p=0.031; r=-0.634, p=0.000), macular hole index and macular hole tractiona index was positively correlated with postoperative best corrected Visual acuity(r=0.600,p=0.001;r=0.416,p=0.025), and hole height, macular hole form factor, retinal edema degree,average lumen diameter, average number of base angle and postoperative best corrected Visual acuity were not related. The MHI ≥ 0.5 group of postoperative best corrected Visual acuity was significantly higher than the MHI<0.5 group, the MHI≥0.5 group of height value is significantly higher than the MHI<0.5 group, the MHI≥0.5 group of minimum liner diameter and base diameter value is significantly lower than the MHI<0.5 group.Conclusion: 1、The minimum liner diameter,base diameter as well as macular hole index and macular hole tractiona index is associated with postoperative best corrected Visual acuity.2、MHI=0.5 can be used as a limit, and MHI values can be used as the prognosis of predicting visual outcome for following surgery for idiopathic macular holes. 3、Diameter of the hole size is a major factor in determining prognosis of Visual acuity. |
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