OCULAR FACTORS RELATED TO PREOPERATIVE ENLARGEMENT OF IDIOPATHIC MACULAR HOLE DIAMETER

Purpose: To determine the preoperative factors that are significantly correlated with an enlargement of an idiopathic macular hole (MH) during the one-month preoperative period. Methods: This was a retrospective cross-sectional study of patients with MH who had undergone vitrectomy in the Kagoshima University Hospital. The stage of the MH was determined by using spectral domain optical coherence tomography. Patients who had optical coherence tomography images at two time points more than 14 days apart before the vitrectomy were studied. Results: The MH participants were at Stage 2 in 44 eyes, at Stage 3 in 58 eyes, and at Stage 4 in 38 eyes. The rate of increase of the hole diameter was 26.0 +/- 42.3% at Stage 2, 5.52 +/- 15.5% at Stage 3, and 8.04 +/- 18.7% at Stage 4. The rate of change at Stage 2 was significantly greater than that at Stage 3 and Stage 4 (both P < 0.01). In Stage 2, the MH diameter at the initial visit was significantly and negatively correlated with the rate of MH enlargement (r = -0.35, P = 0.021). Conclusion: Patients with Stage 2 MHs, especially eyes with small hole diameter, should be considered for early surgery.

Automated summary

This study found that the enlargement rate of macular hole (MH) in patients during the one-month preoperative period is influenced by the stage of MH and the initial diameter of the hole. Patients with Stage 2 MH, especially those with a smaller hole diameter, should be considered for early surgical treatment.