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catherine Jamison, Nicola B Quinn, Usha Chakravarthy, Tunde Peto, Frank Kee, Ian Young, Bernadette McGuinness, Ruth Hogg; Prevalence and severity of macular holes in an ageing population from Northern Ireland. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3951.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence and severity stage of macular holes in patients who participated in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA)
The NICOLA study is a multidisciplinary longitudinal population based study of ageing. Retinal imaging at the NICOLA study health assessment included stereo colour fundus photography (Canon CX-1, Tokyo, Japan), spectral domain optical coherence tomography (SD-OCT) (HRA+OCT; Heidelberg Engineering, Heidelberg, Germany). These were graded by NetwORC UK ophthalmic Reading Centre. Macular holes were reported under ‘Other Pathology’. Images for eyes selected as having macular hole then regraded and staging added for those that were deemed a ‘true’ macular hole, if participants had attended follow-up studies and images were available; these were also examined and staged.
Of the 3393 patients (mean age 63, S.D. 9.03) who attended the eye component of the study there were 6611 eyes (97%) with gradable OCT cube scans. The prevalence of any stage of a macular hole was 0.008%, with 54 eyes from 53 patients graded as having some stage of macular hole. A total of six out of 56 eyes (10.7 %) were diagnosed with a true macular hole, 19 (33.9%) with a pseudo-hole due to epiretinal membrane (ERM), 13 (23.2%) with abnormal foveal contour (AFC), nine (16.1%) with a lamellar hole, four (7.1%) with cysts, and three (5.4%) with vitreomacular traction (VMT)-related changes. The six true macular holes consisted of 4 (66.7%) stage 4 macular holes and 2 (33.3%) stage 1 macular holes. Six eyes had follow up visits and of these; one stage 4 macular hole remained the same 22 months later, two AFCs did not change between visits (20, and 22 months later), one VMT resolved at follow-up 21 months later, one did not have OCT images for the return visit, and a case of pseudohole due to ERM, that had progressed to a stage 4 macular hole 17 months later.
Macular holes can be difficult to study due to low prevalence in the general population. The use of OCT enabled differentiation between degrees of macular hole, showing that the majority of cases were pseudo-holes due to ERM and VMT, or lamellar holes, with true macular holes accounting for 10.7 % of eyes. Where true macular holes did occur, these were predominantly advanced.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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