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Allison Ramsey Soneru, Sanket Shah, Angelo P Tanna; Classification System for Hypotony Maculopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5629.
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© ARVO (1962-2015); The Authors (2016-present)
To develop an objective, reproducible classification system for hypotony maculopathy.
Medical records at a single tertiary care center between 2010 and 2015 of patients with a diagnosis of hypotony who underwent macular imaging with spectral domain optical coherence tomography (OCT) of the hypotonous eye were retrospectively reviewed. Those patients with measured intraocular pressure (IOP) of 0-6 and also a CPT code for macular OCT on the same visit were identified using Enterprise Data Warehouse, an institution-wide electronic database of medical records. The OCTs of these patients were analyzed using Free Ruler 1.7b5 (Pascal, Brooklyn, NY), a two-dimensional pixel screen ruler. 1 unit was defined as 1 Bruch’s membrane thickness. A best-fit second order polynomial equation was fit to Bruch’s membrane, and vertical offsets were calculated to characterize the variable degrees of folding and distortion in the macular architecture. The standard deviations (SDs) of these offsets were used to quantify and grade the severity of the maculopathy. 1 unit was defined as 1 Bruch’s membrane thickness.
195 eyes of 195 patients were evaluated. 67 were excluded due to history or presence of uveitis, and a smaller number were excluded due to insufficient imaging or confounding macular pathology. Eyes included in the analysis were divided into grades 0, 1, 2 and 3. No definite maculopathy was found for SDs between 0 and 0.4, and this was defined as grade 0; Grade 1 (mild) maculopathy was defined as SDs 0.4-0.7; Grade 2 (moderate) maculopathy was defined as SDs 0.7-1.0; and Grade 3 (severe) maculopathy was defined as SDs>1.0.
An objective grading system for hypotony maculopathy is important and necessary to enable further analyses of risk factors and prognostication. To this end, data on demographics, refractive error, age, gender, baseline visual acuity, baseline IOP, as well as visual acuity and IOP at the time of hypotony, were also collected and analyzed. While we comment on the trends found here, ideally a prospective study would next be designed to further analyze risk factors and prognostic factors.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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