Abstract
Purpose :
Great variability exists in the size and shape of idiopathic macular holes, which affects the type of closure after vitreoretinal surgery. We performed a retrospective, observational study to analyse the effect of horizontal and vertical posterior pole curvature on the morphology of macular hole.
Methods :
Eyes with a diagnosis of idiopathic macular hole were included. Baseline hole parameters like minimum linear diameter (MLD) and baseline hole diameter (BHD) were calculated. Macular hole angle and posterior pole curvature were measured in the form of the angle of curvature in both horizontal and vertical meridian at 6 mm and adjacent to the hole separately using imageJ software, as per Figure 1.
Results :
A total of 52 eyes of 52 patients (17 males 35 females), with a mean age of 66.2 ±7.9 years, were included. The median duration of symptoms before presentation was 2.5 months (IQR 1 to 12 months).Horizontal MLD showed weak correlation with average horizontal hole angle (r=-0.29, p=0.05); average vertical hole angle (r=-0.29, p=0.04). Horizontal BHD showed significant correlation with the horizontal posterior pole curvature below the hole (p=-0.47, p<0.001); mean change in curvature (r=-0.29, p=0.03); average horizontal hole angle (r=-0.47, p<0.001). Vertical MLD showed correlation with average horizontal hole angle (r=-0.29, p=0.04) and average vertical hole angle (r=-0.34, p=0.02). Vertical BHD showed correlation with horizontal posterior pole curvature (r=-0.39, p=0.004) and vertical posterior pole curvature (r=-0.31, p=0.03); curvature at 6mm point in vertical meridian (r=-0.37, p=0.006), average vertical curvature (r=-0.37, p=0.007). Horizontal hole height showed correlation with vertical posterior pole curvature (r=-0.350, p=0.01); vertical average curvature (r=-0.339, p=0.01) (Figure 2). On multivariate regression analysis, factors favoring a type 2 closure include, lower superior hole angle and higher inferior to superior average curve ratio.
Conclusions :
The curvature of the posterior pole and macular hole angle was seen to be correlating with the size and shape of the hole, and the type of closure after surgery. Future studies with bigger sample size are required to validate it further.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.