Hole Diameter Ratio for Prediction of Anatomical Outcomes in Stage III or IV Idiopathic Macular Holes

Abstract Purpose: To determine whether preoperative hole diameter ratio (HDR) is a predictive factor for postoperative anatomical outome for stage III or IV idiopathic macular holes (IMHs).Methods: One-hundred and one eyes with stage III or IV IMH were included in this retrospective case series study.
All cases were treated with vitrectomy combined with internal limiting membrane (ILM) peeling and room air tamponade. The macular hole (MH) minimum and maximum diameter was measured on preoperative optical coherence tomography (OCT) images. The HDR was defined as the minimum to maximum diameter ratio. Results: Eighty-one eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The preoperative minimal diameter (703.6±116.1mm vs. 597.6±120.1mm, P<0.01) and HDR (0.6±0.1 vs. 0.5±0.1, P=0.01) were both significantly smaller in postoperative closed eyes. The closure rate of IMHs with HDR<0.6 was significantly higher than those with HDR³0.6 (90.2% vs. 65.0%P=0.002) .Conclusions: Preoperative HDR<0.6 is predictive for a good postoperative anatomical outcome in stage III or IV IMHs.