Baumann, Carmen, Hoffmann, Saskia, Almarzooqi, Ahmed, Johannigmann-Malek, Navid, Lohmann, Chris P and Kaye, Stephen B 
ORCID: 0000-0003-0390-0592
(2021)
Defining a Cutoff for Progression of Macular Holes.
Translational vision science & technology, 10 (13).
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Abstract
<h4>Purpose</h4>The purpose of this study was to determine a cutoff for progression of idiopathic full-thickness macular hole (MH) size.<h4>Methods</h4>Retrospective analysis of consecutive patients waiting 4 weeks for MH surgery. Two observers performed 3 repeat sets of MH size measurements on optical coherence tomography (OCT) high-density radial scans taken at first presentation and 4 weeks later before surgery. Primary outcome was the definition of a cutoff for true enlargement of MH size versus measurement error. Secondary outcomes were risk factors for change in minimum linear diameter (MLD) size and best-corrected visual acuity (BCVA).<h4>Results</h4>Fifty-one patients were included with a mean MH size of 334 µm (±179 µm; range 39 to 793 µm). The cutoff for an increase in MLD size calculated as the outer confidence limit for the 99.73% limits of agreement was 31 µm. This was independent of MH size. Using this cutoff, MLD size increased in 9/34 (26.5%) of patients without and in 14 of 17 (82.4%) of patients with vitreomacular traction (VMT; P < 0.001). Mean BCVA deteriorated in patients in whom the MH had progressed from 0.62 (±0.23) logMAR to 0.82 (±0.29; P < 0.001), whereas there was no significant change in BCVA in patients without MH progression (P = 0.25). In 31% (16/51) of patients, classification of their MHs (small ≤250 µm, medium 251-400 µm, and large >400 µm) changed over the 4-week period.<h4>Conclusions</h4>Using a cutoff discriminates change from measurement error. A significant proportion of MHs progressed by 4 weeks, particularly in the presence of VMT.<h4>Translational relevance</h4>The established cutoff enables clinicians to differentiate true MH enlargement from measurement error.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Retina, Humans, Retinal Perforations, Tomography, Optical Coherence, Retrospective Studies, Visual Acuity |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 01 Feb 2022 16:42 |
| Last Modified: | 18 Jan 2023 21:14 |
| DOI: | 10.1167/tvst.10.13.2 |
| Open Access URL: | https://doi.org/10.1167/tvst.10.13.2 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3147972 |
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