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Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography.

ABSTRACT: It has been known that some traumatic macular holes can close spontaneously. However, knowledge about the types of macular hole that can close spontaneously is limited. In this retrospective study, we investigated patients with traumatic macular hole who were followed-up for at least 6 months without any surgical intervention. Clinical data and spectral domain optical coherence tomography (SD-OCT) images were compared between groups with and without macular hole closure. Overall, 27 eyes were included. Spontaneous closure of macular hole was observed in 10 (37.0%) eyes. The holes with spontaneous closure had smaller minimum diameter (244.9 ± 114.4 vs. 523.9 ± 320.0 μm, p = 0.007) and less intraretinal cysts (10% vs. 76.5%, p = 0.001) compared to the holes that did not close spontaneously. The area under the curve of receiver operative characteristic was 0.812 and 0.832 for minimum diameter of macular hole and presence of intraretinal cysts respectively. Multivariate logistic regression showed that the presence of intraretinal cysts was an independent predictive factor for closure of macular holes. The group with spontaneous macular hole closure had a high chance of visual improvement. Our study suggests that the absence of intraretinal cysts on SD-OCT can predict spontaneous closure of traumatic macular hole.

SUBMITTER: Chen H

PROVIDER: S-EPMC4508835 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:PurposeDescribe qualitative spectral-domain optical coherence tomography (SD-OCT) characteristics of eyes classified as intermediate age-related macular degeneration (nonadvanced AMD) from Age-Related Eye Disease Study 2 (AREDS2) color fundus photography (CFP) grading.DesignProspective cross-sectional study.ParticipantsWe included 345 AREDS2 participants from 4 study centers and 122 control participants who lack CFP features of intermediate AMD.MethodsBoth eyes were imaged with SD-OCT and CFP. The SD-OCT macular volume scans were graded for the presence of 5 retinal, 5 subretinal, and 4 drusen characteristics. In all, 314 AREDS2 participants with ?1 category-3 AMD eye and all controls each had 1 eye entered into SD-OCT analysis, with 63 eyes regraded to test reproducibility.Main outcome measuresWe assessed SD-OCT characteristics at baseline.ResultsIn 98% of AMD eyes, SD-OCT grading of all characteristics was successful, detecting drusen in 99.7%, retinal pigment epithelium (RPE) atrophy/absence in 22.9%, subfoveal geographic atrophy in 2.5%, and fluid in or under the retina in 25.5%. Twenty-eight percent of AMD eyes had characteristics of possible advanced AMD on SD-OCT. Two percent of control eyes had drusen on SD-OCT. Vision loss was not correlated with foveal drusen alone, but with foveal drusen that were associated with other foveal pathology and with overlying focal hyperreflectivity. Focal hyperreflectivity over drusen, drusen cores, and hyper- or hyporeflectivity of drusen were also associated with RPE atrophy.ConclusionsMacular pathologies in AMD can be qualitatively and reproducibly evaluated with SD-OCT, identifying pathologic features that are associated with vision loss, RPE atrophy, and even possibly the presence of advanced AMD not apparent on CFP. Qualitative and detailed SD-OCT analysis can contribute to the anatomic characterization of AMD in clinical studies of vision loss and disease progression.Financial disclosure(s)Proprietary or commercial disclosure may be found after the references.

Project description:To describe the features of foveal microvasculature using optical coherence tomography angiography (OCTA) and to determine the related clinical factors in eyes with surgically closed macular hole (MH).A retrospective case series of 18 patients with unilateral MH was reviewed. The patients maintained complete hole closure after vitrectomy with inner limiting membrane (ILM) peeling for at least 12 months. The healthy fellow eyes were studied as controls. The foveal microvasculature of both eyes was examined by OCTA. The area of the foveal avascular zone (FAZ) and the vascular density (VD) ratio in the superficial and deep capillary plexuses (SCP and DCP) were determined after surgery. Several clinical factors including age, stage and dimensions of MH, papillofoveal distance, the extent of nasal displacement of the fovea after surgery, postoperative central foveal thickness, and outer-retina integrity were evaluated to determine any relationships with the OCTA parameters.The mean FAZ area in both the SCP and DCP (0.29?±?0.11 mm2 and 0.39?±?0.14 mm2) was significantly smaller than those of the controls (0.45?±?0.14 mm2 and 0.62?±?0.22 mm2) (p?=?0.001 and <0.001, respectively). The mean VD ratio in the SCP (0.270?±?0.349) was similar to that of the controls (0.321?±?0.189) (p?=?0.231); however, that in the DCP (0.321?±?0.189) was significantly lower than that of the controls (0.331?±?0.119) (p?=?0.025). Only the extent of nasal displacement of the fovea was correlated with the DCP FAZ-area difference values between the study group and the controls (correlation coefficient?=?0.577; p?=?0.012).After successful MH surgery, the FAZ area in both the SCP and DCP was smaller and the VD ratio of the DCP was lower, suggesting a possible DCP vulnerability to tractional stress. As the FAZ area of the DCP in closed-MH eyes became smaller than that in the controls, the fovea was less displaced toward the optic disc, possibly reflecting a lack of retinal redundancy caused by horizontal stretching accompanied by foveal displacement.

Project description:Importance:Whether optical coherence tomography angiography (OCT-A) outperforms OCT to detect glaucoma remains inconclusive. Objective:To compare (1) the diagnostic performance for detection of glaucoma and (2) the structure-function association between inner macular vessel density and inner macular thickness. Design, Setting, and Participants:This cross-sectional study included 115 patients with glaucoma and 35 healthy individuals for measurements of retinal thickness and retinal vessel density, segmented between the anterior boundary of internal limiting membrane and the posterior boundary of the inner plexiform layer, over the 3 × 3-mm2 macula using swept-source OCT. All participants were Chinese. Visual sensitivity corresponding to the 3 × 3-mm2 macular region was expressed in unlogged 1/lambert for investigation of the structure-function associations. Diagnostic performance was evaluated with area under the receiver operating characteristic curves (AUCs). The study was conducted between January 12, 2016, and December 12, 2016. Main Outcomes and Measures:Area under the receiver operating characteristic curve and R2 analysis. Results:Of the 115 patients with glaucoma, 42 (36.5%) were women (mean [SD] age, 53.5 [13.4] years); of the 35 individuals with healthy eyes, 25 (71.4%) were women (age, 60.6 [5.9] years). Inner macular vessel density and thickness were 4.3% (95% CI, 2.4%-6.1%) and 21.1 μm (95% CI, 17.4-24.9 μm) smaller, respectively, in eyes with glaucoma compared with healthy eyes. The AUC of mean inner macular thickness for glaucoma detection was greater than that of mean inner macular vessel density (difference, 0.17; 95% CI, 0.01-0.31; P = .03). At 90% specificity, the sensitivity of mean inner macular thicknesses for detection of glaucoma was greater than that of mean inner macular vessel densities (difference, 29.2%; 95% CI, 11.5%-64.6%; P = .02). The strength of the structure-function association was stronger for mean inner macular thickness than mean inner macular vessel density in the linear (difference in R2 = 0.38; 95% CI, 0.22-0.54; P < .001) and nonlinear (difference in R2 = 0.36; 95% CI, 0.21-0.51; P < .001) regression models. Conclusions and Relevance:In this study, OCT measurement of inner macular thickness shows a higher diagnostic performance to detect glaucoma and a stronger structure-function association than the currently used OCT-A measurement of inner macular vessel density. These findings may suggest that OCT-A of the macula has a limited role in the diagnostic evaluation of glaucoma.

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Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography.

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