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Jerome Vincent Giovinazzo, Steven Agemy, Jessica Lee, Ronald C Gentile; The Aborted Macular Hole: An Optical Coherence Tomography Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1214.
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To describe the spectral-domain optical coherence tomography (SD-OCT) findings in aborted macular holes.
A retrospective chart review of consecutive patients with a diagnosis of an aborted macular hole (MH) was performed. Criteria included a stage 1 macular hole that aborted as confirmed by OCT (Criteria 1) or an eye that had evidence of an aborted MH based on a combination of history, fundus exam, OCT, and fellow eye findings (Criteria 2). Data collected included demographics, eye involved, visual acuity, and fellow eye retinal diagnoses. OCT of the aborted MH was analyzed for abnormalities in the foveal contour, presence/absence of pre-foveal opercula, and pre/intra-retinal abnormalities.
Aborted macular holes were identified in 17 eyes of 14 subjects. Mean age was 66.7±8.9SD years. Twelve (85.7%) of the subjects were women and 2 (14.3%) were men with involvement of both eyes in 3, right eye in 7, and left eye in 4. Mean best-corrected visual acuities (LogMAR) were 0.15±0.20 in the study eyes and 0.30±0.34 in the fellow eyes. Diagnosis of an aborted MH was made using Criteria 1 in 8 eyes (47%) and Criteria 2 in 9 eyes (53%). There were 10 fellow eyes with fundus visibility of which 3 (27.3%) were normal, 5 (45.5%) had a MH or a repaired MH, and 1 each (9.1%) had a lamellar hole and vitreomacular adhesion. OCT of the aborted MH could be separated into 4 different groups based on OCT morphologies. (Group 1): Normal foveal contour with operculum in 5 eyes (29.4%); (Group 2): Normal foveal contour without operculum in 4 eyes (23.5%); (Group 3): Lamellar hole with operculum in 3 eyes (17.6%) and Group 4: Lamellar hole without operculum in 5 eyes (29.4%). Eight eyes (47.1%) had thinning of the umbo with a discontinuous ILM layer. Two eyes in Group 2 and 1 eye in Group 3 were found to have irregularities/discontinuous areas in the ellipsoid zone. All study eyes had an intact and continuous ELM.
Aborted macular holes have a variety of OCT findings that range from apparently normal to marked thinning of the umbo. Despite these changes, eyes with aborted MH generally retain good visual acuity. A consistent OCT feature is preservation of a continuous ELM, which provides insight into the difference in the pathophysiology of aborted versus full-thickness macular holes.
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