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The Case Mix of Patients Presenting with Full-Thickness Macular Holes and Progression before Surgery: Implications for Optimum Management

Lookup NU author(s): David Steel

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Abstract

Aims: Analysis of pre-operative spectral domain optical coherence tomography (SD-OCT) characteristics of full-thickness macular holes (FTMH) and effect on optimum management. Methods: We retrospectively reviewed SD-OCT characteristics of a consecutive cohort of patients waitlisted for FTMH surgery and categorized them by current evidence-based treatments. Results: Out of the 106 holes analysed, 36 were small, 40 medium and 30 large. Initially, 33 holes had vitreomacular adhesion (VMA). 41 holes were analysed for change in characteristics with a median duration of 8 weeks between the scans. The number of small or medium holes decreased from 20 to 6 and that of large holes doubled. The number of holes with VMA halved. Smaller hole size (p = 0.014) and being phakic (p = 0.048) were associated with a larger increase in size. The strongest predictor of hole progression into a different surgical management category was the presence of VMA. Conclusion: FTMH characteristics can change significantly pre-operatively and affect optimal treatment choice. (C) 2015 S. Karger AG, Basel


Publication metadata

Author(s): Madi HA, Dinah C, Rees J, Steel DHW

Publication type: Article

Publication status: Published

Journal: Ophthalmologica

Year: 2015

Volume: 233

Issue: 3-4

Pages: 216-221

Print publication date: 01/06/2015

Online publication date: 27/02/2015

Acceptance date: 14/01/2015

ISSN (print): 0030-3755

ISSN (electronic): 1423-0267

Publisher: Karger

URL: http://dx.doi.org/10.1159/000375378

DOI: 10.1159/000375378


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