Assessing the Ability of Preoperative Quantitative Spectral-Domain Optical Coherence Tomography Characteristics to Predict Visual Outcome in Idiopathic Macular Hole Surgery

Mehta, Nitish; Lavinsky, Fábio; Larochelle, Ryan; Rebhun, Carl B; Mehta, Nihaal; Yanovsky, Rebecca L.; Cohen, Michael N.; Lee, Gregory D.; Ishikawa, Hiroshi; Wollstein, Gadi; Schuman, Joel S.; Waheed, Nadia K.; Modi, Yasha S.

doi:10.1097/iae.0000000000002797

Cited by 8 publications

(10 citation statements)

References 56 publications

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“…Minimum MH size has been reported to be a common predictor for post-MH surgery visual outcome. [15][16][17] However, the current multivariable analysis demonstrated that minimum MH size was not statistically significant for 1-year visual acuity outcome, and there were no differences in baseline visual acuity and 1-year visual acuity among different MH sizes. This unexpected finding could be attributed to the relatively small sample size.…”

Section: Discussioncontrasting

confidence: 57%

Three-Dimensional Quantification of Intraretinal Cystoid Spaces Associated With Full-Thickness Macular Hole

Tsuboi

Guo

Wang

et al. 2022

Retina

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Purpose: To evaluate intraretinal cystoid spaces in patients with idiopathic macular hole (MH). Methods: Retrospective cohort study included consecutive patients with full-thickness MH who underwent successful MH surgery and 12 months of follow-up. Custom software was applied to preoperative optical coherence tomography scans to generate fluid volume. Inner fluid volume was defined as cystoid spaces in the inner nuclear layer, and outer fluid volume was defined as cystoid spaces in Henle fiber layer of the outer nuclear layer. Results: Thirty-nine eyes from 39 participants were included. Postoperative 12-month visual acuity correlated with both inner fluid volume and minimum MH size (both P < 0.05) but not outer fluid volume. Inner fluid volume positively correlated with minimum MH size (P = 0.0003). After accounting for minimum MH size with multivariable analysis, inner fluid volume effect on VA remained significant (P = 0.025). After dividing inner fluid volume into tertiles, mean baseline visual acuity was 20/50 in eyes with small inner fluid volume, and was 20/125 in eyes with large inner fluid volume (P = 0.0039). Mean postoperative 12-month visual acuity was 20/20 in eyes with small inner fluid volume compared with 20/32 in eyes with large inner fluid volume (P = 0.019). Conclusion: Increased inner fluid volume was associated with worse postoperative VA.

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Section: Discussioncontrasting

confidence: 57%

Three-Dimensional Quantification of Intraretinal Cystoid Spaces Associated With Full-Thickness Macular Hole

Tsuboi

Guo

Wang

et al. 2022

Retina

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“…Mehta et al reported that preoperative FTMH hypertransmission size was associated with postoperative visual function, and it may represent a new and easy-to-visualize predictive imaging biomarker for FTMH management. 25 Because the FTMH sizes obtained with the novel proposed method and the standard method were not found to be identical, future studies will be needed to determine if this novel measurement strategy would potentially reclassify FTMH and alter the expected outcomes of treatments or if, on the contrary, the differences in the FTMH size obtained by the two methods is clinically negligible and expected outcomes of the new method are similar to the old, more labor intensive and subjective method.…”

Section: Discussionmentioning

confidence: 99%

Full-Thickness Macular Hole Size by Hypertransmission Signal on Spectral-Domain Optical Coherence Tomography

Louzada

Ferrara

Moult

et al. 2021

Retina

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Purpose: To assess the full-thickness macular hole (FTMH) size using the choroidal hypertransmission signal on spectral-domain optical coherence tomography and to compare this method to the standard aperture measurement of the minimum aperture size at the level of the neurosensory retina.Design: Cross-sectional study of retrospective data. Methods: Eyes with FTMH imaged on spectral-domain optical coherence tomography were included. Two independent masked graders used the device's built-in caliper tool to measure the FTMH minimum aperture size at the level of the neurosensory retina and the size of the corresponding hypertransmission signal below the level of the retinal pigment epithelium/Bruch membrane complex. To assess the reproducibility of the hypertransmission measurement in tilted scans, two measurements were obtained and compared; the first was traced parallel to the retinal pigment epithelium (parallel hypertransmission), and the second was horizontal to the image frame (horizontal hypertransmission), both using Image J software.Results: A total of 31 eyes were enrolled. The mean FTMH minimum aperture size was smaller compared with both the choroidal parallel hypertransmission and horizontal hypertransmission measurements (mean ± SD: 335.7 ± 139.5 mm, 376.7 ± 150.6 mm, 375.1 ± 150.0 mm, respectively. P , 0.001 for both comparisons). Conclusion:The proposed hypertransmission measurement is a feasible and reproducible alternative to assess FTMH size and could provide the basis for an automated FTMH measurement on cross-sectional spectral-domain optical coherence tomography scans, as presented in this study, or on the spectral-domain optical coherence tomography volumetric data set by using an en face projection.

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“…There was no significant difference in BCVA between the overall air group and the overall silicone oil group. Because some studies had shown that the improvement of visual function was closely related to both the MMHD and the closure rate of IMH [24][25] , each group was subdivided according to MMHD in our study. It was found that BCVA of MMHD1 air group was better than silicone oil group, but significant difference was not found in MMHD2 between the two tamponades.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of idiopathic macular holes treated by vitrectomy with air or silicone oil tamponade based on the hole size

Yin¹,

Jin²,

Jia³

2022

Int J Ophthalmol

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AIM: To compare the efficacy of vitrectomy combined with air or silicone oil in the treatment of idiopathic macular hole (IMH). METHODS: According to the results of high-definition optical coherence tomography (HD-OCT), 75 cases (75 eyes) of IMH in stage II-IV (Gass stage) in the General Hospital of Chinese PLA from January 2017 to December 2019 were collected for this retrospective study. The best corrected visual acuity (BCVA) and minimum diameter of IMH (MMHD) were measured. Eyes underwent vitrectomy combined with internal limiting membrane peeling operation, and were divided into disinfection air group (30 eyes) and silicone oil group (45 eyes) according to the intraocular tamponade. For MMHD≤400 μm (MMHD1), there were 23 eyes in air group and 16 eyes in silicone oil group. For MMHD2>400 μm (MMHD2), there were 7 eyes in air group and 29 eyes in silicone oil group. One month after surgery, the closure rates of IMH and BCVA were compared and analyzed. According to HD-OCT, the closure shape was graded with A (bridge closure) and B (good closure). RESULTS: The closure rates of air group and silicone oil group were 86.67% and 95.56% respectively with no significant difference (P>0.05); For MMHD1, those of air group and silicone oil group were 95.65% and 100% respectively with no significant difference (P>0.05); For MMHD2, those of air group and silicone oil group were 57.14% and 93.10% respectively, and those of the silicone oil group were higher than the air group (P<0.05). There was no significant difference in the closure shape grade between MMHD1 air group and silicone oil group (P>0.05). The proportion of Grade B in MMHD2 silicone oil group was higher than that in the air group (P<0.05). BCVA of each group after operation was better than that before operation, and there was no significant difference between air group and silicone oil group. While among them, MMHD1 air group was better than silicone oil group (P<0.05), and there was no significant difference between MMHD2 air group and silicone oil group (P>0.05). CONCLUSION: For smaller IMH (≤400 μm), the efficacy of vitrectomy combined with air should be considered better than silicone oil; for larger IMH (>400 μm), the efficacy of silicone oil may be better than air.

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Assessing the Ability of Preoperative Quantitative Spectral-Domain Optical Coherence Tomography Characteristics to Predict Visual Outcome in Idiopathic Macular Hole Surgery

Cited by 8 publications

References 56 publications

Three-Dimensional Quantification of Intraretinal Cystoid Spaces Associated With Full-Thickness Macular Hole

Three-Dimensional Quantification of Intraretinal Cystoid Spaces Associated With Full-Thickness Macular Hole

Full-Thickness Macular Hole Size by Hypertransmission Signal on Spectral-Domain Optical Coherence Tomography

Comparison of outcomes of idiopathic macular holes treated by vitrectomy with air or silicone oil tamponade based on the hole size

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