July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Assessment of lamellar macular hole and macular pseudohole with a combination of en face and radial B-scan optical coherence tomography imaging
Author Affiliations & Notes
  • Hirano Masayuki
    Okayana University Hospital, Okayama, Japan
  • Yuki Morizane
    Okayana University Hospital, Okayama, Japan
  • Shuhei Kimura
    Okayana University Hospital, Okayama, Japan
  • Mio Hosokawa
    Okayana University Hospital, Okayama, Japan
  • Yusuke Shiode
    Okayana University Hospital, Okayama, Japan
  • Shinichiro Doi
    Okayana University Hospital, Okayama, Japan
  • Shinji Toshima
    Okayana University Hospital, Okayama, Japan
  • Kosuke Takahashi
    Okayana University Hospital, Okayama, Japan
  • Mika Hosogi
    Okayana University Hospital, Okayama, Japan
  • Atsushi Fujiwara
    Okayana University Hospital, Okayama, Japan
  • Ippei Takasu
    Takasu Eye Clinic, Okayama, Japan
  • Fumio Shiraga
    Okayana University Hospital, Okayama, Japan
  • Footnotes
    Commercial Relationships   Hirano Masayuki, None; Yuki Morizane, None; Shuhei Kimura, None; Mio Hosokawa, None; Yusuke Shiode, None; Shinichiro Doi, None; Shinji Toshima, None; Kosuke Takahashi, None; Mika Hosogi, None; Atsushi Fujiwara, None; Ippei Takasu, None; Fumio Shiraga, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 671. doi:
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      Hirano Masayuki, Yuki Morizane, Shuhei Kimura, Mio Hosokawa, Yusuke Shiode, Shinichiro Doi, Shinji Toshima, Kosuke Takahashi, Mika Hosogi, Atsushi Fujiwara, Ippei Takasu, Fumio Shiraga; Assessment of lamellar macular hole and macular pseudohole with a combination of en face and radial B-scan optical coherence tomography imaging. Invest. Ophthalmol. Vis. Sci. 2018;59(9):671.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The international classification of lamellar macular hole (LMH) and macular pseudohole (MPH) was proposed in 2013 (Ophthalmology, 2013). However, with the advances in optical coherence tomography (OCT), it has been pointed out that there are cases where it is difficult to distinguish between LMH and MPH with the classification and there is still debate over the definition of these diseases. To clarify these issues, we retrospectively assessed both LMH and MPH using a combination of en face and radial B-scan images and compare the results with the conventional classifications.

Methods : En face and radial B-scan OCT images of 63 eyes of 60 patients diagnosed with LMH or MPH based on an international classification were reviewed. Cases were classified using en face images based on the presence/absence of epiretinal membrane (ERM), retinal folds, parafoveal epicenter of contractile ERM (PEC-ERM), and retinal cleavage. We compared the en face imaging-based classification system with the international classification system using radial B-scan images. We quantitatively evaluated visual function and macular morphology. Main outcome measure was characterization of multimodal OCT-based subtypes of LMH and MPH.

Results : All cases showed ERM and were classified into 4 groups. In the first group, which lacked retinal folds and showed significantly lower visual acuity than the other groups (p<0.001, one-way ANOVA), 81% of eyes had degenerative LMH. In the second group, which lacked PEC-ERM and retinal cleavage and showed significantly lower retinal fold depth (p=0.012, one-way ANOVA), all eyes had MPH. The third group, in which 95% of eyes had symmetric tractional LMH, included eyes with retinal cleavage but without PEC-ERM, and this group showed higher circularity of the foveal aperture and cleavage area than the group with both these features (p<0.001, one-way ANOVA, p=0.03, unpaired t test, respectively), in which all eyes had asymmetric tractional LMH.

Conclusions : Multimodal OCT enables classification of LMH and MPH based on pathological conditions. Retinal traction in particular is key to difference in morphology of LMH and MPH.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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