The Significance of the External Limiting Membrane in the Recovery of Photoreceptor Layer after Successful Macular Hole Closure: A Study by Spectral Domain Optical Coherence Tomography

Abstract

Purpose: To evaluate the external limiting membrane (ELM) by spectral domain optical coherence tomography (SDOCT) and its correlation with the inner segment/outer segment (IS/OS) line in patients with successful macular hole surgery. Procedures: Forty-five eyes were divided into 3 groups according to the interval between surgery and first examination. In the first group the interval was between 6 and 12 months, in group 2 it was >12 months and ≤24 months, and in group 3 it was >24 months. The IS/OS and ELM of participants’ eyes were postoperatively assessed using SDOCT in 2008 and 12 months later. Results: A statistically significant association between the integrity of the ELM and the IS/OS junction line was observed in postoperative examinations in all 3 groups. Eyes with a complete IS/OS junction line had an intact ELM. Between the first and the second examinations, a significant improvement in best-corrected visual acuity (BCVA) was noted only in group 1. A positive statistical association was also observed in group 1 between restoration of the IS/OS junction line and improvement in BCVA over follow-up. Conclusions: The restoration of the IS/OS junction line is directly related to the integrity of the ELM.