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Analysis of the progression rate of idiopathic macular holes and the optimal cut-off for baseline minimum linear diameter and base diameter

  • Clinical Investigation
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Abstract

Purpose

To determine the cut-off points of minimum linear diameter (MLD) and base diameter (BD) at which the progression rate of idiopathic full-thickness macular holes (MHs) decreases before vitrectomy.

Study design

A retrospective study.

Methods

We investigated the differences in MLD and BD between baseline and operation days in patients with stages 2, 3, and 4 MHs using optical coherence tomography (OCT). Each difference in OCT parameters was divided by the time interval to calculate the MH progression rates and the cut-off points of MLD and BD.

Results

Overall, 269 patients (282 eyes) were included. It took an average of 36.02 ± 24.69 (7–197) days from baseline to operation. MLD and BD progressed faster in stages 2 and 3 without posterior vitreous detachment (PVD) than in stage 4 with PVD (MLD: p < 0.001 and p = 0.007; BD: p < 0.001 and p = 0.019, respectively). Simple linear regression showed the relationship between baseline MLD and BD, and the progression rate; the progression rate decreased as baseline MLD (p = 0.004) and BD increased ( p < 0.001). For baseline MLD and BD, the cut-off points where the progression rate decreased were 306.0 and 470.0 μm, respectively.

Conclusion

The group without PVD progressed faster than the group with PVD. Moreover, the progression rates were faster in MHs with MLD < 306.0 μm and BD < 470.0 μm. In these patients, vitrectomy without delay is expected to improve the visual prognosis.

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Funding

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF-2020R1F1A1074898). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Statistical consultation was supported by the Department of Biostatistics of the Catholic Research Coordinating Center.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Joo Young Kim, Rae Young Kim, Mirinae Kim, Young Gun Park & Young-Hoon Park

  2. Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Joo Young Kim, Rae Young Kim, Mirinae Kim, Young Gun Park & Young-Hoon Park

  3. Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Hyeon Woo Yim

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  1. Joo Young Kim
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Correspondence to Young-Hoon Park.

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Conflicts of interest

J. Y. Kim, None; R. Y. Kim, None; M. Kim, None; Y. G. Park, None; H. W. Yim, None; Y. H. Park, None.

Previous posting

This manuscript was posted as a preprint on Research Square on 29 Dec, 2022. https://doi.org/10.21203/rs.3.rs-2389966/v1.

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Corresponding Author: Young-Hoon Park

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Kim, J.Y., Kim, R.Y., Kim, M. et al. Analysis of the progression rate of idiopathic macular holes and the optimal cut-off for baseline minimum linear diameter and base diameter. Jpn J Ophthalmol 68, 96–104 (2024). https://doi.org/10.1007/s10384-023-01044-0

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  • DOI: https://doi.org/10.1007/s10384-023-01044-0

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