Macular hole with epiretinal proliferation: diagnostic value of en-face optical coherence tomography and clinical characteristics

Jaehwan Choi; Sang Jin Kim; Se Woong Kang; Ki Young Son; Sungsoon Hwang

doi:10.1007/s00417-024-06446-5

Macular hole with epiretinal proliferation: diagnostic value of en-face optical coherence tomography and clinical characteristics

Graefes Arch Clin Exp Ophthalmol. 2024 Mar 19. doi: 10.1007/s00417-024-06446-5. Online ahead of print.

Authors

Jaehwan Choi^{1

2}, Sang Jin Kim³, Se Woong Kang⁴, Ki Young Son⁵, Sungsoon Hwang³

Affiliations

¹ Department of Ophthalmology, Kyung Hee University Medial Center, Kyung Hee University, Seoul, Korea.
² Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
³ Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁴ Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. swkang@skku.edu.
⁵ Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea.

PMID: 38499794
DOI: 10.1007/s00417-024-06446-5

Abstract

Purpose: To elucidate the clinical features and surgical outcomes of full-thickness macular hole (FTMH) with epiretinal proliferation (EP) diagnosed by both en-face and B-mode optical coherence tomography (OCT).

Method: This retrospective cohort study classified idiopathic FTMHs into two groups, based on B-scan and en-face OCT imaging: FTMH with EP (EP group) and without EP (non-EP group). The preoperative features, as well as postoperative outcomes up to 12 months, were compared between the two groups.

Result: Among 318 eyes of idiopathic FTMH that met the inclusion criteria, 59 eyes (18.6%) were in the EP group, and others were in the non-EP group. In 9 eyes (15.3%) out of the EP group, EP was not detected in the preoperative B-mode OCT but was identified through the en-face OCT. Baseline features showed a higher male proportion (47.5% vs. 27.8%, P = 0.005) and a lower incidence of vitreofoveal traction (P < 0.001) in the EP group than in the non-EP group. The EP group showed worse visual recovery than the non-EP group (- 0.23 vs. - 0.41 logarithm of the minimum angle of the resolution at 12 months, P = 0.001).

Conclusion: The en-face OCT enhances diagnostic accuracy of EP in FTMH eyes, especially in the case with smaller extent of EP. Eyes with FTMH with EP showed a worse visual recovery than FTMH without EP.

Keywords: Epiretinal proliferation; Full thickness macular hole; Surgical outcome.