Three-Dimensional Quantification of Intraretinal Cystoid Spaces Associated With Full-Thickness Macular Hole

Abstract

Purpose: To evaluate intraretinal cystoid spaces in patients with idiopathic macular hole (MH). Methods: Retrospective cohort study included consecutive patients with full-thickness MH who underwent successful MH surgery and 12 months of follow-up. Custom software was applied to preoperative optical coherence tomography scans to generate fluid volume. Inner fluid volume was defined as cystoid spaces in the inner nuclear layer, and outer fluid volume was defined as cystoid spaces in Henle fiber layer of the outer nuclear layer. Results: Thirty-nine eyes from 39 participants were included. Postoperative 12-month visual acuity correlated with both inner fluid volume and minimum MH size (both P < 0.05) but not outer fluid volume. Inner fluid volume positively correlated with minimum MH size (P = 0.0003). After accounting for minimum MH size with multivariable analysis, inner fluid volume effect on VA remained significant (P = 0.025). After dividing inner fluid volume into tertiles, mean baseline visual acuity was 20/50 in eyes with small inner fluid volume, and was 20/125 in eyes with large inner fluid volume (P = 0.0039). Mean postoperative 12-month visual acuity was 20/20 in eyes with small inner fluid volume compared with 20/32 in eyes with large inner fluid volume (P = 0.019). Conclusion: Increased inner fluid volume was associated with worse postoperative VA.