Temporal Correlation of Photoreceptor Layer Healing in spectral domain optical coherence tomography with visual outcomes after vitrectomy in stage 4 macular holes.

Objective: To evaluate the temporal relationship between visual outcomes after pars plana vitrectomy in stage 4 macular holes (MD) and photoreceptor layer healing in spectral domain optical coherence tomography (SD-OCT). Materials and Methods: Thirty-three eyes of 33 consecutive patients with stage 4 MD were included in the retrospective noncomparative study. MD base diameter, MD height, and photoreceptor layer inner segment/outer segment (IS/OS) defect diameter were measured in SD-OCT. Defect length values ​​in the IS/OS band were compared with Bonferroni-corrected t-test at 1, 3, and 6 months preoperatively and postoperatively. The Pearson correlation coefficient between IS/OS defect diameter and BCVA was calculated at the preoperative and postoperative 1st, 3rd and 6th months. Results: Preoperative and postoperative 1st month, 3rd month and 6th month BCVA were 0.86±0.26 (0.5-1.6) logMAR, respectively; 1.0±0.32 (0.5-1.6) log-MAR; It was 0.77±0.32 (0.4-1.7) logMAR and 0.72±0.27 (0.4-1.3) logMAR (p=0.024; p=0.034 and p=0.540, respectively). The mean defect length in the IS/OS band of the patients before and after the surgery at the 1st, 3rd and 6th months was 1350.84±339.56 (865.0-2311.0) µ, respectively; 874.36±409.63 (174.0- 1705.0) µ; 540.30±329.52 (158.0-1406.0) µ and 397.12±294.69 (150.0-1444.0) µ (p=0.000, p=0.000 and p=0.000, respectively). Pearson correlations between IS/OS band defect length and BCVA preoperatively p=0.002 r=0.610; 1 month postoperatively p=0.16 r=0.25; p=0.35 r=0.17 at 3 months and p=0.017 r=0.411 at 6 months. Conclusion: Although the recovery of the photoreceptor layer in SD-OCT after vitrectomy in macular holes is maximum in the first month, the visual results can improve up to the 6th month.

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