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Matthew Farajzadeh, Anibal Andres Francone, Lisa Yun, Jean-Pierre Hubschman; Full-thickness macular hole with lamellar macular hole associated epiretinal proliferation: a morphological analysis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3153. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study is to assess the morphological differences between full-thickness macular hole (FTMH) with and without lamellar macular hole associated epiretinal proliferation (LHEP).
In this retrospective observational case series, data from patient charts and spectral-domain optical coherence tomography (OCT) images was collected from 2007 through 2017. Baseline medical and ophthalmologic history was assessed. Best-corrected visual acuity (BCVA) was evaluated at baseline, post-operative month (POM) 1, POM 3, and at the last follow up visit. BCVA values were converted to LogMar for statistical analysis. FTMH basal diameter, minimum diameter and maximum height were measured using the caliper function of the Heidelberg Eye Explorer (version 220.127.116.11). Macular hole index (height/basal diameter) was also assessed.
76 eyes were diagnosed with FTMH according to OCT findings. Areas of LHEP were identified in 25 eyes. The mean age at the time of surgery was 70 years old. 31(72%) patients were female and 11(28%) patients were male. The Best corrected visual acuity (BCVA) of patients in both groups was collected. Improvement in BCVA over time was compared between groups was compared using a mixed model analysis. While patients with FTMH+ LHEP group had worse mean final BVCA, no statistical difference was found. On OCT, FTMH basal diameter (Mean FTMH+LHEP=1656 μm, FTMH=920μm), minimum diameter (mean FTMH+LHEP=531μm, FTMH=431.7μm), maximum height (mean FTMH+LHEP=432μm, FTMH=385.27μm), and macular hole index (mean FTMH+LHEP=0.261, FTMH=0.487) were shown to be statistically significant across all measurements (p=0.0129, p= 0.038, p=0.0287, and p=0.0317 respectively) using the Mann-Whitney t-test.
In conclusion, the presence of LHEP in patients with FTMH was associated with increased size of FTMH basal diameter, minimum diameter, and height. Further investigation is needed to determine whether or not these anatomical changes have any significant association with functional and surgical outcomes.
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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