FULL-THICKNESS MACULAR HOLE IN AGE-RELATED MACULAR DEGENERATION PATIENTS WITH TWO DISTINCT ENTITIES: A Multicenter Study. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Rabina, Gilad; Pillar, Shani; Nemet, Achia; Mimouni, Michael; Levinger, Nadav; Chowers, Itay; Ehrlich, Rita; Gal-Or, Orly; Barequet, Dana; Rosenblatt, Amir; Moisseiev, Elad; Greifner, Hillel; Magal, Itay; Segal, Ori
• Is Part Of: Retina. Volume 41:Issue 10(2021)
• Publication Date: 2021-10
• Subjects: full-thickness macular hole -- traction -- degenerative -- AMD -- OCT; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003141
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To describe optical coherence tomography characteristics of full-thickness macular holes (FTMHs) in age-related macular degeneration patients. Methods: A multicenter, retrospective, observational case series of patients diagnosed with age-related macular degeneration and FTMHs seen between January 1, 2009, and January 3, 2020. Clinical charts and spectral-domain optical coherence tomography images were reviewed. Optical coherence tomography findings included FTMH-inverted trapezoid or hourglass appearance, central macular thickness (CMT), complete retinal pigment epithelium and complete retinal outer retinal atrophy, and presence of pigment epithelium detachment and epiretinal membrane. The mean outcome was the morphologic and functional characterization of different subtypes of FTMHs. Results: A total of 86 eyes of 85 consecutive patients, with mean age of 80.31 ± 8.06 and mean best-corrected visual acuity of 1.17 ± 0.58 logarithm of the minimal angle of resolution. Two different subtypes of FTMHs were identified: tractional and degenerative. Fifty (58%) degenerative FTMHs characterized with inverted trapezoid appearance and 36 (42%) tractional FTMHs characterized with hourglass appearance. Degenerative FTMHs presented with 66% of CMT < 240 µ m, 14% of CMT > 320, and 70% of complete retinal outer retinal atrophy, in comparison with 41% of CMT < 240 µ m, 42.9% of CMT > 320%, and 20% of complete retinal outer retinal atrophy in the tractional FTMH group ( P = 0.002, 0.003, <0.001, respectively). The presence of epiretinal membrane and pigment epithelium detachment where significantly higher in tractional FTMHs ( P = 0.02, 0.03, respectively). Conclusion: Degenerative and tractional FTMHs may be two distinct clinical entities. Discerning degenerative from tractional FTMHs is possible by using optical coherence tomography features including shape of the FTMHs, CMT, internal–external ratio of FTMHs, and presence of complete retinal outer retinal atrophy, pigment epithelium detachment, and epiretinal membrane. Abstract : Full-thickness macular holes in age-related macular degeneration patients can be divided into tractional and degenerative subgroups. Discerning degenerative from tractional full-thickness macular holes is possible by using optical coherence tomography features including shape of the full-thickness macular holes, central macular thickness, presence of complete retinal outer retinal atrophy, pigment epithelium detachment, and epiretinal membrane.