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- Title:
Defining a Cutoff for Progression of Macular Holes.
- Document type:
- Journal Article
- Author(s):
- Baumann, Carmen; Hoffmann, Saskia; Almarzooqi, Ahmed; Johannigmann-Malek, Navid; Lohmann, Chris P; Kaye, Stephen B
- Abstract:
- Purpose: The purpose of this study was to determine a cutoff for progression of idiopathic full-thickness macular hole (MH) size. Methods: Retrospective analysis of consecutive patients waiting 4 weeks for MH surgery. Two observers performed 3 repeat sets of MH size measurements on optical coherence tomography (OCT) high-density radial scans taken at first presentation and 4 weeks later before surgery. Primary outcome was the definition of a cutoff for true enlargement of MH size versus measurement error. Secondary outcomes were risk factors for change in minimum linear diameter (MLD) size and best-corrected visual acuity (BCVA). Results: Fifty-one patients were included with a mean MH size of 334 µm (±179 µm; range 39 to 793 µm). The cutoff for an increase in MLD size calculated as the outer confidence limit for the 99.73% limits of agreement was 31 µm. This was independent of MH size. Using this cutoff, MLD size increased in 9/34 (26.5%) of patients without and in 14 of 17 (82.4%) of patients with vitreomacular traction (VMT; P < 0.001). Mean BCVA deteriorated in patients in whom the MH had progressed from 0.62 (±0.23) logMAR to 0.82 (±0.29; P < 0.001), whereas there was no significant change in BCVA in patients without MH progression (P = 0.25). In 31% (16/51) of patients, classification of their MHs (small ≤250 µm, medium 251-400 µm, and large >400 µm) changed over the 4-week period. Conclusions: Using a cutoff discriminates change from measurement error. A significant proportion of MHs progressed by 4 weeks, particularly in the presence of VMT. Translational Relevance: The established cutoff enables clinicians to differentiate true MH enlargement from measurement error.
- Journal title abbreviation:
- Transl Vis Sci Technol
- Year:
- 2021
- Journal volume:
- 10
- Journal issue:
- 13
- Fulltext / DOI:
- doi:10.1167/tvst.10.13.2
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/34727163
- TUM Institution:
- Klinik und Poliklinik für Augenheilkunde
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