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kotaro tsuboi, Yukun Guo, JIE WANG, Motohiro Kamei, David Huang, Yali Jia, Thomas S Hwang, Steven T Bailey; Three-dimensional quantification of intraretinal cystoid space in patients with macular hole. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1890.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize and quantify intraretinal cystoid spaces in patients with macular hole (MH).
We conducted a retrospective, observational study which included consecutive, MH patients who underwent successful MH closure after a primary surgery with 12-month follow-up postoperatively. We obtained 3×3-mm macular optical coherence tomography scans with a commercial device preoperatively and processed with a custom software. The software detected the intraretinal cystoid spaces in each of B-scan images and quantified as fluid volume (FV) (Figure). We defined inner FV as cystoid spaces in the inner nuclear layer and outer FV as cystoid spaces between the outer plexiform layer and the Henle’s fiber layer. MH was classified with the International Vitreomacular Traction Study (IVTS) classification. Spearman’s correlation coefficient was used for univariate analysis. In multivariate analyses, variables that were a P value less than 0.10 in the univariate analysis were selected by forward stepwise selection for linear regression models.
Forty-two eyes of 39 patients were included. Eleven eyes (26%) were small MH, 12 eyes (29%) were medium MH, and 19 eyes (45%) were large MH. Sixteen eyes (38%) had vitreomacular traction (VMT). Of 42 eyes, 39 eyes (93%) underwent combined phacovitrectomy and all eyes were pseudophakia postoperatively. Large MH was associated with increased inner FV compared to small MH (P = 0.0026), while there were no differences in the outer FV between MH size. Inner and outer FV was similar in eyes with and without VMT. Postoperative VA was significantly associated with the inner FV (ρ = 0.39, P = 0.0097), while minimum MH size (ρ = 0.29, P = 0.063), basal MH size (ρ = 0.20, P = 0.21), and outer FV (ρ = -0.053, P = 0.74) were not. In multivariate analysis, the inner FV was the only significant factor for postoperative 12-month VA (β = 0.44, P = 0.0033).
Inner FV is associated with larger MH size based on IVTS classification and worse postoperative VA. These suggest inner FV represents retinal degenerative change associated with more advanced MH.
This is a 2021 ARVO Annual Meeting abstract.
Assessment of intraretinal cystoid space as FV. (A) An OCT B-scan image. (B) Inner FV which exist in the INL is labeled in green and outer FV which exist between OPL and HFL is labeled in red. (C) All 304 B-scan images are merged to generate the volumetric data (D) showing 3-D distribution of inner FV and outer FV.
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