Baseline OCT Biomarkers and Early Outcomes After Idiopathic Full-Thickness Macular Hole Surgery: Associations with Primary Failure and Visual Acuity After Successful Closure

Background/Objectives: Baseline visual acuity (VA) and minimum linear diameter (MLD) are well-established predictors after surgery for idiopathic full-thickness macular hole (FTMH). It is less clear whether other optical coherence tomography (OCT) features provide additional information. We examined the associations of selected baseline OCT biomarkers with primary anatomical failure and with early postoperative VA after successful closure.

Methods

We retrospectively studied eyes that underwent surgery for idiopathic FTMH at a single Swiss center between 2019 and 2024. Primary failure was assessed exploratorily using Firth penalized logistic regression. Early postoperative VA was analyzed among eyes with successful primary closure and an eligible visit 21–60 days after surgery. Linear regression models included baseline VA and MLD, with each OCT biomarker added separately. Patient-level cluster-robust standard errors accounted for bilateral inclusion.