CORRELATIONS BETWEEN PREOPERATIVE RETINAL PIGMENT EPITHELIAL PROTRUSIONS AND POSTOPERATIVE OUTCOMES IN EYES WITH IDIOPATHIC MACULAR HOLES. 
To determine the relationship between the alterations in the preoperative morphology of the retinal pigment epithelium (RPE) and the postoperative recovery after surgery to close an idiopathic macular hole (MH).  Retrospective interventional case series.  Fifty-nine eyes of 59 patients with an idiopathic MH were studied.  Pars plana vitrectomy was performed with the removal of the internal limiting membrane.  The best-corrected visual acuity was measured, and the retinal morphology, including the presence of small RPE protrusions at the bottom of MH, was determined by spectral domain optical coherence tomography before and at 1, 3, and 6 months postoperatively.  The mean age of the patients was 66.7 years.  Forty eyes (68%) had preoperative alterations of the RPE.  The minimal (P < 0.001) and the base (P < 0.001) diameters of the MH were significantly larger in eyes with preoperative RPE alterations.  The best-corrected visual acuity was significantly worse at baseline (P = 0.014) and at 6 months postoperatively (P = 0.048) in the eyes with RPE alterations.  The defect of the ellipsoid zone was significantly longer in eyes with baseline RPE alterations at 1, 3, and 6 months postoperatively (P < 0.001, P = 0.001, and P = 0.032).  The presence of RPE protrusions at baseline was significantly correlated with slower morphologic recovery and poorer visual acuity after MH closure.