Significant Correlation Between Visual Acuity and Recovery of Foveal Cone Microstructures After Macular Hole Surgery

Abstract

To determine whether a recovery of the microstructures of the foveal photoreceptors after macular hole closure is correlated with best-corrected visual acuity (BCVA). Retrospective, consecutive, observational case series. Single-center academic practice. Forty-one eyes of 41 patients with surgically closed macular holes. OBSERVATIONAL PROCEDURES: The presence and intactness of the cone outer segment tips (COST) line were determined by spectral-domain optical coherence tomography and compared with the presence of the inner segment/outer segment (IS/OS) junction and the external limiting membrane (ELM) at 1, 3, 6, 9, and 12 months after the macular hole surgery. The correlation between the integrity of the foveal photoreceptor microstructures and the BCVA. A distinct COST line was first seen at 6 months after the surgery. A distinct or irregular COST line was observed only in eyes with an intact IS/OS junction and ELM. Eyes with a distinct or irregular COST line had significantly better BCVA than those with a disrupted COST line in eyes with an intact IS/OS junction and ELM at 12 months (P = .030). The BCVA was ≥20/25 at 12 months in 91% of the eyes with a distinct or irregular COST line but in only 44% of the eyes without a COST line (P = .015). The significant correlation between the BCVA and a distinct or irregular COST line after successful macular hole surgery indicates that the recovery of foveal cone microstructure is associated with good postoperative BCVA.