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CLASSIFICATION OF FULL-THICKNESS TRAUMATIC MACULAR HOLES BY OPTICAL COHERENCE TOMOGRAPHY

HUANG, JINGJING MD*; LIU, XING MD, PhD*; WU, ZIQIANG MD; LIN, XIAOFENG MD, PhD*; LI, MEI MD*; DUSTIN, LAURIE MS; SADDA, SRINIVAS MD§

doi: 10.1097/IAE.0b013e31819241d0
Original Articles
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Purpose: To describe morphologic features of traumatic macular holes on optical coherence tomography and to correlate them with clinical findings.

Methods: Seventy-three consecutive patients diagnosed with full-thickness traumatic macular holes involving the fovea underwent complete ophthalmic evaluation followed by horizontal and vertical line scans using the Stratus optical coherence tomography. Retinal thickness at the edges of the holes, apical and basal diameters, and various clinical parameters were recorded. The approximate apical and basal areas and eccentricities of the holes were calculated. Morphologic parameters were correlated with clinical findings.

Results: On the basis of optical coherence tomography findings, traumatic macular holes were classified into five morphologic types with varying average retinal thicknesses, apical areas, and basal areas. Patients who presented >90 days after injury had greater average retinal thickness (P = 0.03) and apex areas (P = 0.002) compared with those who presented within 90 days. Older patients developed more circular holes, i.e., less eccentricity of the apex (P = 0.04) and base (P = 0.01). Interestingly, none of the morphologic parameters investigated in the current study correlated with visual acuity. Patients who presented later in the clinical course or who had greater average retinal thicknesses tended to have better vision (P = 0.11 and P = 0.07, respectively).

Conclusions: Optical coherence tomography evaluation may yield important insights into the pathogenesis and clinical findings of traumatic macular holes.

Morphologic features of traumatic macular holes can be discerned by optical coherence tomography and correlated with clinical parameters.

From the *State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China; †Center for Advanced Eye Care, Carson City, Nevada; ‡Department of Preventive Medicine, Keck School of Medicine at University of Southern California; and §Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California.

Supported in part by Grant 2007A060305009 from Guangdong Science and Technology Institute, Grants EY 11753 and EY 03040 from the National Eye Institute and the National Center on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, and an unrestricted grant from the Research to Prevent Blindness, New York, NY.

The authors have no proprietary interest in any of the topics discussed in this manuscript.

Reprint requests: Xing Liu, MD, PhD, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xianlienan Road, Guangzhou 510060, China; e-mail: drliuxing@163.com

© The Ophthalmic Communications Society, Inc.