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The outer nuclear layer changes in full-thickness macular holes according to the restoration of the outer retinal
Seungheon Lee1, Eunseok Kang1, Mihyun Choi2
1Department of Ophthalmology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
Purpose:
This study investigated changes in the outer nuclear layer (ONL) following surgery for idiopathic full-thickness macular holes (MH) based on postoperative outer retinal restoration.
Methods:
We retrospectively analyzed clinical and optical coherence tomography (OCT) data from 56 eyes of 55 MH patients who underwent vitrectomy and achieved hole closure within 12 months. Preoperative MH morphology and ONL thickness in 1 mm and 3 mm ETDRS circles were measured at 1, 6, and 12 months post-surgery. Ellipsoid zone (EZ) restoration was evaluated at 12 months.
Results:
At 12 months, 40 eyes (71.4%) with continuous EZ restoration demonstrated better visual acuity than those with disrupted EZ (0.33vs.0.70, P = 0.006). Continuous EZ restoration was associated with a consistently thicker foveal ONL (1 mm) at all follow-ups (P < 0.001). In these patients, temporal and inferior 3 mm circles exhibited greater ONL thickness at 6 and 12 months (P < 0.05). Foveal 1 mm ONL thickness increased at 12 months compared to 6 months (71.9 μm vs. 69.0 μm, P < 0.001), while temporal and inferior 3 mm circles decreased over time (P = 0.012, 0.001).
Conclusion:
Foveal restoration post-MH surgery correlates with improved visual outcomes, with ONL thickness serving as a potential indicator.
