[OCT in idiopathic macular hole management]

To demonstrate the potential benefit of OCT in the management of IMH and in the post-operative follow-up of the patients with IMH.

Prospective interventional study including 29 patients diagnosed with IMH since april 2002. All the patients underwent OCT of both eyes with the purpose to identify the MH, to define the size of IMH, to determine the stage of MH, to prove the connections between the internal limiting membrane and the posterior hyaloid and to perform differential diagnosis in doubtful cases. We perform surgery for all the cases in stage III and IV and for certain cases in stage II with unsatisfied patients. In stage I and in most of stage II we have performed dynamic follow-up of the patients without surgery.

The patients were followed for 12 months after surgery. We have controlled the visual acuity (decrease, increase or constant) and changes of IMH profile in OCT (closing of MH with a normal foveal profile, smoothing of MH edges, increase of MH size or no change). We observed a normal foveal profile in 20 cases and an increasing in visual acuity in 16 cases. The functional and anatomical behaviour of the patients was influenced by the stage of MH.

OCT gives the possibility to diagnose and staging the MH, but also it offers the possibility to choose the tactics in the management of IMH (taking care of the stage and the hyaloido-foveal traction) and to appreciate the postoperative prognosis. The postop OCT can precisely evaluate the anatomical result of the surgery with the possibility to improve the surgical technique. The management of IMH with the help of OCT is a good choice which gives the possibility to get good functional results and minimize the intra- and postoperative complications.