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Rodrigo Abreu, Lorena Sole, Marta Marmol, Jeroni Nadal; Spectral-Domain Optical Coherence Tomography Features and Prediposing to Macular Hole Developement. Invest. Ophthalmol. Vis. Sci. 2014;55(13):306.
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To investigate the clinical and spectral-domain optical coherence tomographic features of patients with macular hole (MH) compared to normal eyes (NE) subjects and the possible optical coherence tomography predisposing factors for the MH developement.
Retrospective electronic health record based study. Clinical and tomographic features of patients with MH and NE patients were collected. All patients underwent complete ophthalmologic examination including best-corrected visual acuity, slit-lamp biomicroscopy, fundus photography, and spectral domain optical coherence tomography. The features of the retina and the vitreomacular interface were graded based on spectral domain optical coherence tomography thickness. In both groups a tomographic study was performed using 512 x 128 Macular Cube protocol Cirrus-HD OCT (Carl Zeiss Meditec , Dublin , CA).
A total of 202 eyes from 202 patients (100 NE and 102 MH) were analyzed. There were no statistically significant differences in the mean age of both groups (60.86 ± 14.01 Healthy / 62.29 ± 13.62 AM), or gender distribution . MH stage III (30.4%) and MH stage IV (52.9 %) had a higher representation in the sample (79.4 %). Time of MH diagnosis was over a month in 74.5% of the patients. Mean foveal thickness and inner ring perifoveal thickness were significantly higher in men compared to women (p < 0.05 ) in the NE group, however these differences were not statistically significant in the MH group ( p > 0.05). Volume, average thickness of the cube, nasal sectors and upper inner sector of the OCT study decreased with age, statistically significant only in women ( p < 0.05) in the NE group. Women had lower retinal thickness in all sectors of the outer ring in the OCT in the MH group compared to the NE group.
These findings suggest that the retina thinning is being produced with age in healthy women and this retina thinning is maintained in women who develop MH. As women have more thinned retinas, they have lower resistance to vitreomacular traction compared to men who have thicker retinas. These data could stablish a new hypothesis to explain the higher incidence of MH in women compared to men.
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