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Association between a novel four-location outer retinal morphology score and visual outcomes in full-thickness
Mitsuru Otsubo1, Tomoko Ro-Mase2, Shun Konno2
1Department of Ophthalmology, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, Hokkaido, 078-8510, Japan. kyokui090061@gmail.com.
Purpose:
To evaluate the association between a novel four-location outer retinal score (OR score) and postoperative best-corrected visual acuity (BCVA) in eyes with full-thickness macular hole.
Methods:
This retrospective study included eyes undergoing vitrectomy for full-thickness macular hole. Preoperative optical coherence tomography (OCT) was used to assess outer retinal morphology at the macular hole edge in four lacations (temporal, nasal, superior, and inferior) using horizontal and vertical scans. Each location was graded, and the sum was defined as the total OR score. Associations with postoperative BCVA at 3 months were evaluated using Spearman's correlation and multivariable linear regression.
Results:
A total of 48 eyes from 48 patients were included in this study. Four eyes in which primary macular hole closure was not achieved after the initial surgery were excluded from the final analysis of postoperative BCVA at 3 months. The OR score was significantly correlated with postoperative BCVA (ρ = 0.458, p = 0.0018). However, after adjustment for minimum hole diameter, it was not an independent predictor. The OR score was significantly correlated with minimum hole diameter (ρ = 0.522, p < 0.001). Neither the Gass classification nor single cross-sectional OCT classification showed significant associations with postoperative BCVA.
Conclusions:
The four-location OR score was associated with postoperative BCVA and may reflect the severity of outer retinal damage. Its lack of independent predictive value suggests that it captures morphological severity overlapping with minimum hole diameter.