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C.L. Coriat, R. Tadayoni, B. Haouchine, P. Massin, A. Gaudric; OCT Staging of Macular Holes and Surgical Prognosis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1490.
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© ARVO (1962-2015); The Authors (2016-present)
To explore the possibility of a correlation between macular hole (MH) stage and MH diameter measured on OCT scan profile.
We retrospectively reviewed the files of 95 consecutive patients who underwent a primary operation for idiopathic full–thickness MH between March 2004 and April 2005. Duration of symptoms, VA, and biomicroscopic appearance of the MH were noted. All patients had had Stratus OCT 3 examination preoperatively, and 6 radial scans had been performed. Closure of the hole was assessed post operatively by OCT at 3 months. Anatomical success was defined as the recovery of foveal continuity on OCT scan profiles. For each patient, we referred to the preoperative appearance of the vitreo–macular junction, and to the diameter of the hole, measured by OCT. On each of the 6 OCT scan profiles we measured the aperture diameter, that we defined as the smallest distance between the edges of the hole. We also recorded the type of vitreo–macular relationship and the presence or absence of a pseudo–operculum. We established a correlation between the OCT vitreo–foveal appearance on OCT and the Gass classification of macular holes. Statistical analysis was performed with the Kruskal–Wallis test for the comparison of quantitative variables.
Mean MH aperture diameter was 372,6 ± 140,2 for stage 2 MH ( hole with Posterior Hyaloid (PH) still attached to the edge of the hole), 426,1±175,2 for stage 3 MH ( hole with PH detached in front of the macula) and 424,4±163,2 in stage 4 MH ( complete posterior vitreous detachment). There was not statistical difference between these three values (Kruskal–Wallis test p=0.6). There was also no significant correlation between the duration of symptoms and the stage of the hole (Kruskal–Wallis test p=0.1). However, a significant positive correlation was found between the duration of symptoms and the aperture diameter of the hole. (Kruskal–Wallis test p=0.0007).
MH staging is mainly useful for anticipating the need to detach the vitreous during surgery. Several studies have shown that Macular Holes have more chance of being closed by surgery if their aperture diameter was smaller than 400µm. Our study shows that this variable does not correlate with the stage of the hole as determined by biomicroscopy and
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