Novel En Face OCT-Based Closure Patterns in Idiopathic Macular Holes

Abstract

Purpose: To determine the postoperative en face OCT pattern of closure in idiopathic macular holes (MHs).

Design: Retrospective, multicentric, observational study.

Participants: Patients aged > 18 years with a diagnosis of idiopathic MH, with well documented en face OCT images.

Methods: Baseline characteristics and preoperative OCT and en face OCT parameters like horizontal and vertical minimum linear diameter (MLD), horizontal and vertical basal hole diameter (BHD), hole height, acircularity index, and hole orientation were measured.

Main outcome measure: The type of hole closure on en face OCT, and a comparison of baseline parameters and final visual acuity among the en face closure types.

Results: A total of 64 eyes of 62 patients (24 men and 40 women) with a mean age of 63.8 ± 12.4 years. The median duration of symptoms was 3 months (interquartile range, 1.75-10.5). The eyes had a mean baseline visual acuity of 0.97 ± 0.46 logarithm of minimum angle of resolution (logMAR). The baseline horizontal MLD was 591.7 ± 219.4 μm and the vertical MLD was 552.9 ± 198.2 μm. Baseline horizontal and vertical BHD were 1240.3 ± 521.1 μm and 1142.1 ± 478.1 μm, respectively. The mean hole height was 394.8 ± 123.2 μm. Two different patterns were noted on en face OCT: round, or linear. A total of 38 eyes had a round/centripetal closure and 26 eyes had a linear closure (17 eyes had a horizontal closure, 7 eyes had an oblique closure, while 2 eyes had a vertical closure). The mean final visual acuity was 0.80 ± 0.43 logMAR (Snellen equivalent of 20/125). Eyes with linear closure (0.76 ± 0.23 logMAR) had a significantly (P = 0.03) better visual acuity than the round closure group (1.07 ± 0.28 logMAR), only in eyes with horizontal MLD of > 650 μm, but not when other MLD cut-offs were used.

Conclusion: We describe 2 different patterns of hole closure (linear and round) on en face OCT. Further studies will be required to determine its functional significance.

Financial disclosure(s): Proprietary or commercial disclosure may be found after the references.

Keywords: Closure; En face; Internal limiting membrane; MH; Macular hole; OCT.