Purpose:
To evaluate the reproducibility of the measurements obtained using optical coherence tomography (OCT) in idiopathic macular hole eyes.
Methods:
This observational, cross-sectional study included 17 patients with idiopathic macular hole, stages III and IV. Subjects with visually significant cataracts or high myopia (< 6,0) were excluded. Three properly trained retina fellows used the 3mm cross-hair section to acquire separate vertical and horizontal sections of the MH. Each physician measured the MH dimensions on his own set of OCT images. The following parameters were assessed: MH diameter at the level of the retinal pigment epithelium (base diameter), MH diameter at the minimal extent of the hole (minimum diameter), and the hole height at the greatest height from the retinal pigment epithelium to the vitreoretinal interface. Analysis of variance for repeated measures and Bland-Altman plots were performed.
Results:
17 eyes of 17 patients were analyzed. Horizontal base diameter, minimum diameter, and hole height measurements ranged from 698 to 2153µ, 467 to 1122µ, 174 to 639µ respectively. Vertical base diameter, minimum diameter, and hole height measurements ranged from 704 to 2308µ, 302 to 1073µ, 182 to 647µ respectively. The horizontal minimum diameter measured by the three observers showed a statistically significant difference (p=0.031). Table 1 shows the bias and 95% limits of agreement (LOA) for the MH measurements.
Conclusions:
A considerable difference of the MH parameters was observed when measured by three different observers. Position of the scan acquisition and the interobserver variability in measuring MH parameters may account for this poor reproducibility. This variability must be considered when using the MH size measured on OCT images as a prognostic factor in eyes with idiopathic MH.holes.
Keywords: macular holes • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea