Purpose To evaluate whether an index based on hole configuration can be used t o predict visual outcome in eyes with idiopathic macular holes. Design Prospecti ve interventional case series. Methods Thirty five eyes of 32 patients with idi opathic stage 2 or 3 macular hole were enrolled in this study. The best correct ed visual acuity (BCVA), cross sectional image of the macular hole by optical c oherence tomography (OCT), and retinal thickness in the central ( < 1000 μm), i nner (1000 to 2220 μm), and outer ring areas (2220 to 3450 μm) as defined by t he OCT retinal mapping program were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively. The change in retinal thickness of the inner ring ar ea at the 6month postoperative period was used to evaluate the degree of preoper ative retinal deformation. The macular hole index (MHI) (ratio of hole height to base diameter of hole) was calculated and correlated with minimum diameter of h ole, base diameter of hole, the postoperative decrease in macular thickness, and the postoperative BCVA. The postoperative BCVA was further evaluated in two pat ient matched groups. Results Retinal thickness values in the inner ring area we re decreased at the 1 month postoperative period. MHI significantly correlated with the postoperative decrease in macular thickness in the inner ring area at 6 months (correlation coefficient=-0.632, P=.030, Spearman analysis) and with th e postoperative BCVA (P=.013, multiple regression analysis). Postoperative BCVA in the MHI ≥0.5 group was better than that in the MHI < 0.5 group (P= .032, Man n Whitney test). Conclusions The MHI is a ratio easily calculated from OCT tran sverse images of the macular area. The MHI represents the preoperative configura tion of a macular hole and is a prognostic factor for visual outcome.
To investigate the incidence, causative organisms, and visual acuity outcomes associated with endophthalmitis after pars plana vitrectomy. Retrospective, nonc omparative, consecutive case series. The medical records were reviewed of all pa tients who developed acute onset postoperative endophthalmitis (within 6 weeks of surgery) after pars plana vitrectomy at Bascom Palmer Eye Institute between J anuary 1, 1984 and December 31, 2003. During the 20 year study interval, the ov erall incidence rate of postvitrectomy endophthalmitis was 0.039%(6/15,326). Cu ltured organisms were Staphylococcus aureus (n=3), Proteus mirabilus (n=1), and Staphylococcus epidermidis/Pseudomonas aeruginosa (n=1); one case was cul ture negative. Visual acuity after treatment for endophthalmitis ranged from 2/200 to no light perception, with a final vision of light perception or no light perc eption in four of six (67%) eyes. The incidence of endophthalmitis after pars p lana vitrectomy is low but the visual acuity outcomes after treatment are genera lly poor.
