Macular hole morphology and measurement using an automated three-dimensional image segmentation algorithm

Chen, Yunzi; Nasrulloh, Amar Vijai; Wilson, I. J.; Geenen, Caspar; Habib, Maged; Obara, Bogusław; Steel, David

doi:10.1136/bmjophth-2019-000404

Cited by 14 publications

(13 citation statements)

References 25 publications

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“…The effect of MLD change from baseline to postprimary surgery on final outcome was also assessed. Because of the established intra-and interobserver variability in MLD measurement 10,11 we calculated a 10% margin for error. Closure rates of FTMH, which increased in size $10% after primary surgery, were compared with FTMH that had decreased by $10%.…”

Section: Exclusion Criteriamentioning

confidence: 99%

Outcome of Revision Procedures for Failed Primary Macular Hole Surgery

Maguire

Steel

Yorston

et al. 2021

Retina

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To analyze the outcomes of revision surgery for idiopathic full-thickness macular holes that have failed to close after primary surgery, and also to assess factors predicting success and to review the relative effect of adjunctive surgical techniques.Methods: A multicenter retrospective study. Anatomical closure rates and visual acuity change between pre and postrevision surgery were assessed. Hole size, age, symptom duration, surgical interval, and reduced hole size were analyzed as predictive factors for success. Effectiveness of adjunctive surgical techniques was reviewed.Results: Seventy-seven eyes were included in the study. Anatomical closure was achieved in 71% (55/77) cases. There was a median gain of 11 Early Treatment of Diabetic Retinopathy Score letters in all holes and 14 letters in closed holes. Full-thickness macular holes that increased in size by more than 10% following primary surgery had a closure rate of 50% compared with 80% in holes that reduced by 10% or stayed the same (P = 0.015). Increasing hole size is associated with a modest reduction in odds of closure (odds ratio = 0.99; P = 0.04). Surgical interval ,2 months is not associated with better outcomes compared with .2 months (P = 0.14).Conclusion: Revision surgery for full-thickness macular holes that have failed to close after primary surgery is associated with high closure rates and significant visual gains.

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Section: Exclusion Criteriamentioning

confidence: 99%

Outcome of Revision Procedures for Failed Primary Macular Hole Surgery

Maguire

Steel

Yorston

et al. 2021

Retina

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“…However, they did not highlight the implications of this finding except in a more accurate preoperative assessment of hole size. [ 6 ] By advancing the horizontal extent of ILM peeling by an extra 1DD on the temporal side, we successfully closed 95% of the macular holes, with visual improvement in all the eyes. The outer retinal bands (ELM and EZ) were restored more than a half and a quarter of the eyes, respectively; however, delayed structural recovery is common in large macular holes.…”

Section: Discussionmentioning

confidence: 99%

Internal limiting membrane peeling for large macular hole: Tailoring the rhexis to the shape of the hole

Shukla¹,

Kalliath²

2021

Indian Journal of Ophthalmology

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Purpose: To report a simple modification of internal limiting membrane (ILM) peeling tailored to the shape of the macular hole to improve the closure rates. Methods: This is a single-center interventional case series. conducted between 2016 and 2020. The minimum follow-up was 4 months. All surgeries were performed by one surgeon. Twenty consecutive patients (21 eyes) with large idiopathic macular holes (horizontal diameter: ≥600 μm) were enrolled; vertical hole diameters were also measured using spectral-domain optical coherence tomography (OCT). Following vitrectomy, ILM peeling was performed over a horizontally oval area (additional 1 disc-diameter temporally); perfluoropropane gas (C3F8, 15%) tamponade was used. Hole closure and change in best-corrected visual acuity (BCVA) were monitored after absorption of the gas. Preoperative and postoperative visual acuities were compared using paired t-test. IBM SPSS (ver. 26) was used for analysis. Results: The macular holes were horizontally oval rather than circular without exception: mean horizontal and vertical diameters were 714 μm (range: 600–1020 μm) and 602 μm (490–844 μm), respectively. Following vitrectomy, macular hole closure was obtained in 20/21 eyes by the last follow-up (mean: 28 months, median: 34 months; range 4–48 months). Mean Snellen BCVA improved from 20/200 to 20/63 ( P < 0.0001). Conclusion: All the macular holes in the study were observed to be horizontally oval. A corresponding horizontal enlargement of the ILM rhexis yielded excellent anatomical and satisfactory visual outcomes.

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“…Because MHs have been shown not to be perfectly round in shape 14 and their MLD may lie in any meridian, we routinely use a high-density radial OCT scan pattern, which considers all meridians and is likely to improve detection of the largest MLD as compared to a horizontal linear one. As far as we are aware, cutoffs for deciding if an MH has increased or decreased in size have not previously been determined.…”

Section: Discussionmentioning

confidence: 99%