Hole Diameter ratio (HDR) for prediction of anatomical outcomes in stage III and IV idiopathic macular holes
Abstract Summary: In this study, we reviewed 101 eyes with stage III or IV IMHs treated by PPV combined with ILM peeling and room air tamponade, took the ratio of minimum diameter to maximum diameter (hole diameter ratio, HDR) as the predictive factor and found HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome.Purpose: To identify hole diameter ratio (HDR) as the predictive factor for unclosed stage III and IV idiopathic macular holes (IMHs) by the use of preoperative optical coherence tomography (OCT).Methods: 101 eyes with stage III or IV IMH were included in this retrospective case series study. All cases were treated with vitrectomy combined with ILM peeling and room air tamponade. The MH minimum and maximum diameter, the ratio of the minimum to the maximum diameter (which defined as HDR) were performed. Results: 81 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 minimal diameter of IMHs (703.6±116.1um VS 597.6±120.1um, P<0.01) and HDR (0.6±0.1 VS 0.5±0.1, P=0.01) were both significantly different between two groups. The cutoff value of the receiver operating characteristic curve was 0.6. The IMH with the HDR that less than 0.6 were defined as “A” type IMH and the others were defined as “H” type IMH. The closure rate of two type IMHs were 90.2% and 65.0% respectively. It had significant differences. (P=0.002) Conclusions: HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome in stage III and IV IMHs after vitrectomy combined with LM peeling and room air tamponade.