Pre-operative predicting factor in visual outcome after macular hole surgery

Abstract

Objective: To determine the effectiveness of macular hole index (MHI) as a predicting factor of visual outcome after full thickness macular hole surgery.
 Methods: This quasi-experimental study was conducted at LRBT Free Base Eye Hospital, Karachi from January 2018 to March 2019. Total 45 eyes of 45 patients with full thickness macular hole (FTMH) underwent preoperative Best Corrected Visual Acuity (BCVA) assessment with logMar chart and Optical Coherence Tomography (OCT) scanning, with measurement of base diameter and macular hole height. Values were calculated for the macular hole index (MHI), which was taken as the predictive factor. All patients had undergone 25+G trans-conjunctival three ports pars plana vitrectomy, internal limiting membrane peeling, and endo-tamponade of C3F8 (14%). The final visual outcome of all the patients was noted.
 Results: Forty-five patients were included for the study, out of which 10 (22.2%) were male and 35 (77.7%) were female. Age ranged from 45-70 years (mean age 57.20±6.47 years). The mean pre-operative visual acuity was 2.46±1.15 logMar and was 3.88±2.00 logMar, post-operatively. Moreover, 27(60.0%) out of 45 patients achieved BCVA (gain of 2 lines of the logMar chart). The average macular hole index was 1.55±0.50 and out of 45, 25 patients had MHI ≥0.5. It was found that patients with macular hole index ≥0.50 showed clinically significant improvement in BCVA in comparison to those who have macular hole index <0.50.
 Conclusion: Macular hole index can be used to predict functional success in macular hole surgery.
 doi: https://doi.org/10.12669/pjms.36.5.1995
 How to cite this:Feroz L, Rizvi SF, Naz S, Khan MTH. Pre-operative predicting factor in visual outcome after macular hole surgery. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1995
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prognostic Role of Optical Coherence Tomography in Outcome of Idiopathic full thickness Macular Hole Surgery

“…Of 17 patients (HFF > 0.9), 10 (58.82%) patients showed macular hole closure and 7 (41.17%) were remain unclosed. Haritoglou et al 17 also reported the similar results as we find in our study that higher values of HFF are associated with good post-surgical outcomes Feroz et al 9 reported that MHI >0.5 is associated with good visual outcomes. Haroon Tayyab et.…”

“…8 Nowadays OCT (optical coherence tomography) has been playing a pivotal role in macular hole diagnosis and analyzing its preoperative role in visual and anatomical outcomes of macular hole surgery. 9 Ip et. al.…”

Quantitative analysis of morphological characteristics of chronic idiopathic macular hole on spectral-domain optical coherence tomography

“…Compared with MHI < 0.5, the MHI ≥ 0.5 indicates a better visual acuity (ref. 30,31). THI is expressed as the ratio of hole height to minimum diameter, which also re ects the ratio of traction in the perpendicular direction to that in the tangent direction.…”