[Diagnosis and evaluation of macular hole with the HRT 2 retina module]

This prospective study analyzed the usefulness of the HRT 2 retina module as a diagnostic tool for macular hole diagnosis. The influence of the preoperative status on postoperative anatomic and functional results is also discussed. Preoperative and postoperative retinal tomography maps (HRT 2) were compared with optical coherent tomography (OCT III) and spectral optical coherent tomography (SOCT).

Fifty eyes of 46 consecutive patients with stage III/IV macular hole underwent vitrectomy with internal limiting membrane peeling and fluid/air exchange. HRT 2, OCT III, and, in eight cases, SOCT images were analyzed.

The mean best corrected visual acuity 1 week before surgery was 0.086+/-0.074 (0.01-0.35). The final best corrected visual acuity 12 months after surgery was 0.32+/-0.24 (0.01-1.0). Anatomic success was noted in 46/50 eyes 1 month after the first surgery and in all eyes after the second intervention. In 33/50 eyes (66%), visual acuity improved over two lines. In 13 eyes visual acuity remained stable, and in four eyes worse visual acuity was noted postoperatively. The mean macular hole diameter in HRT 2 was 497.2 microm and in OCT III was 490 microm. Different values were observed in cases of oval macular holes. The mean macular hole area was 0.193 mm(2). The macular hole radius in HRT 2 can be compared with the minimal diameter in OCT III. It influences the final visual acuity 12 months after surgery.

The HRT 2 macular module enables diagnosis of macular hole and evaluation of its postoperative status. This technique has some advantages because it enables measurement of the macular hole's radius, area, and depth. In cases when the macular hole's radius as measured in HRT and OCT III differs, HRT seems to give more exact data because it shows the entire surface rather than just a cross-section of the retina. Macular hole radius and area as measured with HRT 2 can influence postoperative functional results.