Clinical Features of Idiopathic Macular Holes

Kumagai, Kazuyuki; Ogino, Nobuchika; Demizu, Seiji; Atsumi, Kazunari; Kurihara, Hideyuki; Iwaki, Masaya; Ishigooka, Hitoshi; Tachi, Naoko

doi:10.1016/s0021-5155(01)00311-2

Cited by 6 publications

(3 citation statements)

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“…Many studies reported that shorter duration of symptoms is correlated with better visual acuity. 6 , 7 , 17 – 20 We found no correlation between visual acuity and the duration of symptoms in both types of closure. Kang and colleagues 6 also reported no correlation between visual acuity and duration of symptoms in their study.…”

Section: Discussioncontrasting

confidence: 53%

“…The correlation of preoperative macular hole size with anatomical success and visual improvement has been reported in many studies in the literature. 13 , 17 – 20 There have been several studies with different types of macular hole measurements like macular hole index, hole form factor, diameter hole index, tractional hole index and macular hole closure index. 13 , 21 – 23 We measured horizontal hole size as the MLD and BHD, and vertical hole size as HH.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic factors affecting macular hole closure types

et al. 2021

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Purpose: In this study, we aimed to evaluate the relationship between macular hole closure types assessed by optical coherence tomography (OCT) and the preoperative prognostic factors. Materials and methods: In total, 183 patients who underwent pars plana vitrectomy and internal limiting membrane peeling for idiopathic macular hole between August 2014 and August 2019 were reviewed retrospectively. The preoperative measurements of the macular hole including minimum linear diameter (MLD), basal hole diameter (BHD) and hole height (HH) were measured on OCT images. The patients were divided into two closure types on the basis of postoperative OCT findings (type 1 closure: retinal edges were flat and there was no defect of the neurosensory retina on the fovea; type 2 closure: retinal edges were flat and there was a defect of the neurosensory retina on the fovea). The difference of prognostic factors such as age; duration of symptoms; preoperative best-corrected visual acuity (BCVA); preoperative macular hole measurements, including MLD, BHD and HH; and rate of reopening between two types were statistically analysed. Results: The mean age of patients was 66.33 ± 8.09 years (range: 48–88 years). According to OCT imaging, 117 eyes (63.9%) were classified into the type 1 closure group, and 66 eyes (36.1%) were classified into the type 2 closure group. There were no significant differences between two groups in age, duration of symptoms and preoperative BCVA ( p = 0.694, p = 0.092 and p = 0.15). MLD and BHD were significantly larger, and reopening was significantly more common in type 2 group ( p < 0.05, p = 0.04 and p < 0.005); however, there was no significant difference in HH between two groups ( p = 0.239). Conclusion: Preoperative horizontal measurements of macular hole may help to determine postoperative visual expectations and anatomical success, and predict the possibility of reopening.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Prognostic factors affecting macular hole closure types

et al. 2021

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“…The reason for this may be because more residual neurosensory retina indicates a better preserved visual function. Several previous reports suggested that the preoperative macular hole size was correlated with anatomical success and visual improvement [15,[16][17][18][19][20] . Our study results indicate that determination of hole closure type depends strongly on the preoperative macular hole diameter among other possible prognostic factors.…”

Section: Discussionmentioning

confidence: 93%

Outcome of macular hole surgery in a peripheral eye care facility of Nepal

Tulsyan,

Azzam,

Shah

2024

Int. J. Med. Ophthalmol.

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Introduction: Macular hole is a full thickness defect of the retina involving anatomical fovea, which is an important cause of central visual loss. Most common cause is idiopathic. The OCT has provided information regarding pathogenesis, classification and surgical success. Purpose: The objective of this study was to find out whether two types of hole closure would show different visual prognosis and to identify the correlation between size of macular hole and the type of closure.Patients and Methods: This study consisted of a retrospective consecutive series of patients who were operated for idiopathic macular hole in R.M. Kedia Eye Hospital from January 2022 to March 2023. Among 35 eyes operated for idiopathic macular hole in the mentioned time frame, 27 eyes of 27 patients with closed macular hole after the initial operation were included in this study. All patients underwent preoperative and postoperative OCT examination of the macular lesion, including the measurement of the macular hole diameter. The successful closure of the macular hole was defined as a postoperative biomicroscopic appearance in which the rim of the macular hole disappeared or was attached to the underlying RPE with flattening of the cuff of retinal detachment around the hole. On the basis of postoperative OCT findings, the closed macular holes were classified into two groups; type 1 and type 2 closure. Results: Type 1 closure was achieved in 18 (67%) of patients and Type 2 closure in 9 (33%) of patients. Stage 2 hole patients had 100% Type 1 closure whereas Stage 3 hole patients had 50% Type 1 and 50% Type 2 closure. Significant mean difference was found in pre-operative and post-operative BCVA (P-value < 0.01). Significant mean difference in pre-operative BCVA and post-operative BCVA was also observed among patients with stage 2 (P-value < 0.01) and stage 3 (P value < 0.01). Conclusion: Smaller preoperative macular hole size will probably result in the complete sealing of the macular hole without bare RPE after operation. And the complete sealing of the macular hole without bare RPE is associated with better visual acuity, more visual improvement and less recurrence postoperatively.

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