Can Perifoveal Pseudocyst Area be a Prognostic Factor in Macular Hole Surgery?

Abstract

To evaluate the effect of perifoveal pseudocysts on the anatomical outcomes of the idiopathic macular hole surgery as a prognostic factor.Twenty-one eyes of 20 consecutive patients with a Gass stage 3 or 4 idiopathic macular hole were enrolled in this prospective study between March 2012 and May 2013. Demographic data, medical history, and ocular examinations were recorded preoperatively and on postoperative day 1, week 1, and month 1, 3, and 6. Five spectral domain optical coherence tomography (SD-OCT) parameters were analyzed: macular hole (MH) basal diameter, MH minimum diameter, MH height, macular hole index, and a new parameter, the area of macular pseudocysts via the software of SD-OCT device at the widest cross section of the MH formation.The mean preoperative best-corrected visual acuity was 0.86 ± 0.29 logarithm of the minimum angle of resolution (LogMAR) (between 0.4 and 1.3) and improved to 0.64 ± 0.28 LogMAR (between 0.22 and 1.23) postoperatively (P = 0.004). There was a statistical significant difference between both MH basal diameter and MH pseudocyst area with anatomical success, respectively (P = 0.016 for MH basal diameter, P = 0.004 for MH pseudocyst area). The anatomical closure was correlated with MH basal diameter and MH pseudocyst area (P = 0.01 and P = 0.001, respectively). Spearman correlation rank coefficient between with MH basal diameter and MH pseudocyst area was r = 0.493 and statistically significant (P = 0.02).Perifoveal pseudocysts seem to be associated with anatomic failure and may be used as a prognostic factor in MH surgery.

The Healing Process and Functional Recovery of Neuroretina after Idiopathic Macular Hole Surgery without Internal Limiting Membrane Reversal Tamponade

“…However, without retina tissue bridging, this early close tendency was followed by further opening of the hole and perifoveal pseudocysts forming as shown in Figure 2. Yuksel et al reported that perifoveal pseudocysts were related to the macular hole unclosed, which was consistent with our results [34]. Smiddy and Flynn found that early macular hole could be self-repaired through retinal tissue junction [35].…”

Changes in Inner and Outer Retinal Layer Thicknesses after Vitrectomy for Idiopathic Macular Hole: Implications for Visual Prognosis

“…Recent advances in ocular imaging technology have successfully enabled more and more detailed analyses to evaluate morphological and functional prognosis in MH formation [ 13 ] and repair [ 14 , 15 ]. To the best of our knowledge, the present study is the first to reveal sequential changes in thickness of inner and outer retinal layers in the macular area following PPV for idiopathic MH and a correlation between photoreceptor anatomical recovery and visual outcomes.…”

Wirkung von autologem Thrombozytenkonzentrat auf den anatomischen und funktionellen Erfolg bei der Chirurgie des Makulaforamens im Spätstadium

“…Ein schlechterer Operationserfolg war bereits früher mit großen basa- len Durchmessern der Makulaforamina vergesellschaftet [12]. Entsprechendes gilt für den Visus [42]. Arbeiten weisen auf Schädigungen der retinalen Mikrostrukturen insbesondere von Fotorezeptoren hin, die gerade bei Patienten mit höheren MF-Stadien festgestellt wurden (dabei kamen bildgebende Techniken wie die OCT und auch elektrophysiologische Methoden zum Einsatz) [32,36].…”