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W. K. Song, S. Kim, S. Lee, H. Koh, S. Byeon; The Relationship of Macular Hole and Axial Length. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1328.
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© ARVO (1962-2015); The Authors (2016-present)
It is widely believed that the tangentially oriented contraction of the premacular vitreous cortex is involved in the pathogenesis of idiopathic macular holes. Generally the age of onset of posterior vitreous detachment (PVD) correlates with the degree of myopia. This study investigated the distribution of axial length (AXL) of idiopathic macular hole patients in Asian population, and how the AXL and sex influences on age at the onset.
The records of patients with full thickness idiopathic macular holes who had undergone macular hole surgery between April 2004 and May 2009 were retrospectively reviewed. Diagnosis and staging were made with indirect ophthalmoscopy and optical coherence tomography(Stratus OCT). AXL and refractive status were measured with A-scan ultrasonic biometry (Tomey UD-6000) and an automatic keratometer (Canon RK-3). Only patients with symptoms present for less than a year were included. Eyes with other retinal diseases or a past history which may influence vitreous configuration (ocular trauma, intraocular surgery, refractive surgery, or ocular laser treatments) were excluded.
One hundred and forty eyes (40 males, 100 females) were identified. The average age was 63.1 ± 8 (range 44-83) years and AXL was 23.47 ± 1.3 mm. The corrected Snellen visual acuity improved from 0.2 to 0.4. In 8 eyes hole closure was unsuccessful. Retinal detachment developed in 8 eyes. The AXL of the patients had a dual peak with highest frequency in 23.7 mm and second small peak at 25.8 mm. The distribution of AXL were not one but two normal distributions (Kolmogorov-Smirnov test p = 0.042). Age at the onset of macular hole showed a significant decrease in relation to AXL (pearson correlation r = -0.401, p < 0.0001) and in female (linear regression; age = 135.61 - 2.74AXL - 4.71sex, (male = 1, female = 2))
The current study revealed that the age at the onset of idiopathic macular hole decreases in eyes with longer AXL and in female. In Asian population where myopia and longer AXL is common, the idiopathic macular holes is relatively more common in short eyes or in eyes with high myopes, relatively sparing moderate myopes.
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