Analysis of progression rate of idiopathic macular hole and optimal cut‐off for baseline minimum linear diameter and base diameter

Abstract

AbstractPurpose: To determine the cut‐off points of minimum linear diameter (MLD) and base diameter (BD) at which the progression rate of idiopathic macular hole (MH) decreases before vitrectomy.Methods: This retrospective study compared optical coherence tomography (OCT) taken at baseline and on operation day for patients with stage 2, 3, and 4 idiopathic MH to determine the changes in MLD, BD, height, and MH index. The idiopathic MH progression rate was calculated by dividing each difference in OCT parameters by the time interval.Results: A total of 244 eyes of 235 patients were included. The average age of the patients was 64.12 ± 7.69 (40–85) years. The average time interval from baseline to operation was 36.65 ± 25.20 (7–197) days. Unclosed MHs were found in 14 eyes (5.7%). The progression rate obtained through simple linear regression decreased as the baseline MLD and BD increased (p = 0.044 and p = 0.002, respectively). The optimal cut‐off points obtained through piecewise regression were 295.0 μm for MLD and 414.0 μm for BD.Conclusions: In idiopathic MH with MLD < 295.0 μm or BD < 414.0 μm, the progression rates of MLD and BD were significantly faster. It would ultimately be beneficial for visual prognosis to perform vitrectomy without delay in patients with idiopathic MH with an MLD < 295.0 μm or BD < 414.0 μm.