Non-Invasive Retinal Imaging Modalities for the Identification of Prognostic Factors in Vitreoretinal Surgery for Full-Thickness Macular Holes

Abstract

In this review, we will focus on different non-invasive retinal imaging techniques that can be used to evaluate morphological and functional features in full-thickness macular holes with a prognostic purpose. Technological innovations and developments in recent years have increased the knowledge of vitreoretinal interface pathologies by identifying potential biomarkers useful for surgical outcomes prediction. Despite a successful surgery of full-thickness macular holes, the visual outcomes are often puzzling, so the study and the identification of prognostic factors is a current topic of interest. Our review aims to provide an overview of the current knowledge on prognostic biomarkers identified in full-thickness macular holes by means of different retinal imaging tools, such as optical coherence tomography, optical coherence tomography angiography, microperimetry, fundus autofluorescence, and adaptive optics.

Persistent Macular Hole Management Options

“…OCT is essential in measuring various aspects of FTMHs, including their size, base diameter, height, and the macular hole index (height/maximum basal diameter). The minimum linear dimension, representing the horizontal span between the closest retinal components, is a critical factor in assessing anatomical success postsurgery and forms the basis of an international OCT-based classification system for FTMH [16].…”

“…Smaller hole diameters tend to lead to better postoperative visual acuity. Recent investigations have explored additional OCT structural features as predictors of functional recovery after surgery [16].…”

“…Structural OCT also allows the identification of three hyper-reflective bands within the external retinal layers: the external limiting membrane (ELM), the ellipsoid zone (EZ), and the interdigitation zone (IZ). Restoration of these bands is often associated with improved visual acuity after FTMH surgery, with the preoperative length of defects serving as a strong predictor of visual acuity outcomes [16].…”

“…Furthermore, FTMHs may be associated with intraretinal cystoid cavities around their edges, which expand and separate retinal layers during hole formation. The presence of these cysts has shown mixed correlations with postoperative outcomes, varying by study [16].…”

Tekhnologiya mikrohirurgicheskoj rekonstrukcii fovea pri makulyarnyh razryvah

“…Идиопатический макулярный разрыв представляет собой фовеальный дефект, затрагивающий все нейроретинальные слои и характеризующийся снижением остроты зрения, возникновением центральной скотомы и метаморфопсий [1][2][3][4]. По данным литературы, частота развития макулярного разрыва составляет примерно 3-5 случаев на 1000 человек старше 55 лет, чаще возникает у женщин в возрасте 60-70 лет.…”