• Comprehensive Ophthalmology

    This retrospective study found that both reproducibility and imaging alignment may affect the ability of OCT to predict visual outcomes following macular hole surgery, and that photoreceptor inner segment/outer segment (IS/OS) defect length was the most reliable predictor of visual outcomes among OCT parameters.

    Subjects were 49 patients (50 eyes) who underwent macular hole surgery with preoperative cross-section OCT images taken on and off the center of the macular hole. In each image, the following OCT parameters were either measured or calculated: minimum diameter, base diameter, hole height, temporal and nasal arm length, photoreceptor inner segment/outer segment (IS/OS) defect length, hole form factor, macular hole index and tractional hole index.

    Although the reproducibility of OCT parameter values was moderate to high, there was a significant difference in mean measurement values between the on- and off-center images. Predictive values varied between sessions and raters, and only the preoperative photoreceptor IS/OS defect length consistently showed significant correlation with postoperative visual outcome at six months.

    The authors conclude that based on its robustness against the effects of sessions, raters, and imaging alignment, the preoperative IS/OS defect length in the on-center image is one of the most reliable and promising predictive factors for good postoperative vision following macular hole surgery. Ophthalmologists should keep in mind that most OCT-based parameter values could be affected by various factors and therefore the most reliable parameter should be selected to predict postoperative visual outcomes.