Clinical characteristics and visual outcome of patients with macular pseudohole

To evaluate clinical features and visual outcomes in macular pseudohole (MPH) and to investigate associations between visual acuity and optical coherence tomography (OCT) parameters in patients with MPH.

We retrospectively reviewed consecutive patients with MPH who underwent vitrectomy and were followed for at least 6 months after surgery. MPH was diagnosed based on spectral-domain OCT findings. Analysed factors included axial length, spherical equivalent, overlapping cases of epiretinal membrane foveoschisis (ERM-FS) and lamellar macular hole (LMH), presence of glaucoma, preoperative and postoperative best-corrected visual acuity (BCVA), presence of inner and outer retinal cysts, epiretinal proliferation (EP) and ellipsoid zone (EZ) disruption.

This study enrolled 76 eyes of 75 patients, with overlapping cases that included MPH+ERM FS (17 eyes), MPH+LMH (18 eyes) and MPH+ERM FS + LMH (3 eyes). BCVA significantly improved from 0.29±0.25 preoperatively to 0.06±0.17 postoperatively (p<0.001). Preoperative BCVA and the presence of EP exhibited significant associations with worse postoperative BCVA (p<0.0005 and p<0.05, respectively). Presence of EZ disruption at 3 and 6 months postoperatively was associated with worse postoperative BCVA (p<0.001 and p<0.01, respectively).

There was significant improvement in patients with MPH after undergoing surgery. Current results suggest preoperative poor visual acuity, preoperative presence of EP and postoperative EZ disruption are negative prognostic factors for visual outcomes.