Abstract
Purpose :
Macular hole is a frequent retinal pathology that depends on the clinical ability of a specialist for its diagnosis. The purpose of this study is to document the clinical findings used by ophthalmology residents for a presumptive diagnosis of macular hole before confirmation with optical coherence tomography (OCT).
Methods :
A retrospective analysis of 105 patients (n= 115 eyes) that attended an initial visit between January 2015 to December 2015 with a macular hole diagnosis. The clinical findings were considered as follows: Best Corrected Visual Acuity (BCVA), Amsler test and fundoscopic characteristics such as posterior vitreous detachment (PVD), macular hole (MH), epiretinal membrane (ERM), macular folds and Watzke-Allen sign. These findings were documented from each evaluation and total frequencies were calculated.
Results :
: 115 eyes were analyzed, 65 being women and 40 being men. The median age of diagnosis was 59.1 and the right eye was found to be affected in 56 (49.1%) patients, therefore being the most common. Only 10 (8%) patients had both eyes affected. The median BCVA was 0.80 LogMar. A total of 17 (16%) Amsler tests were done, of which 9 (52%) were positive for metamorphopsia and 2 (11%) for central scotoma. The Watzke-Allen sign was evaluated in 59 (51.7%) patients, where 43 (73%) were found positive and 13 (22%) negative. The fundoscopic examination revealed PVD in 7 (5%) patients, MH in 105 (92%) patients, ERM in 25 (22%) patients and macular folds in 7 (6%) patients.
Conclusions :
The presumptive clinical diagnosis of macular hole done by residents did not require a systematic and detailed exploration of the patient. The image of macular hole and the positive Watzke-Allen sign were the most conclusive data and the most used to consider the diagnosis during baseline visit. The diagnosis was confirmed afterwards with an OCT at the retina department.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.