Comparison of optical coherence tomography image features between traumatic macular hole and idiopathic macular hole_Chinese Journal of Ocular Fundus Diseases

Authors：

Shi Tingkun , Xia Honghe , Jin Chuang , Ke Xixuan , Zhang Qi , Liao Xulong , Cheng Yinglin , Huang Yuqiang ,  Chen Haoyu

Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, China;

Corresponding author：

Chen Haoyu, Email: drchenhaoyu@gmail.com

Keywords：

Traumatic macular hole; Idiopathic macular hole; Optical coherence tomography; Central retinal thickness

DOI：

10.3760/cma.j.cn511434-20240902-00327

Video：

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Objective To comparatively observe optical coherence tomography (OCT) image features between traumatic macular hole (TMH) and idiopathic macular hole (IMH). Methods A retrospective clinical study. A total of 174 patients (174 eyes) with macular hole (MH) diagnosed at Shantou International Eye Center from December 2008 to May 2024 were included in the study. Among them, there were 75 patients (75 eyes) with TMH and 99 patients (99 eyes) with IMH, and they were divided into the TMH group and the IMH group accordingly. All the affected eyes underwent best corrected visual acuity (BCVA) and OCT examinations. The BCVA was examined using a standard logarithmic visual acuity chart, and was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The minimum diameter and basal diameter of the MH, as well as the average, nasal, superior, inferior, and temporal retinal thickness (CRT) around the MH were measured by OCT. The independent-sample t test was used to compare the logMAR BCVA, hole diameter, and CRT at the hole margin between the groups. Results There were significant differences in age (t=－15.857) and gender ratio (χ²=28.154) between the TMH group and the IMH group (P＜0.05), while there was no significant difference in logMAR BCVA (t=1.962, P＞0.05). The minimum diameter of the hole in the TMH group was smaller than that in the IMH group, but the basal diameter was larger, with significant differences (t=－3.322, 2.570; P＜0.05). The thickness of the neuroepithelial layer at the hole margin in the TMH group was thinner than that in the IMH group, with significant differences in the superior (t=－2.747), inferior (t=－2.316), and nasal (t=－2.851) regions (P＜0.05), and no significant difference in the temporal region (t=－1.586, P＞0.05). In the TMH group, the number of eyes with macular cystoid edema (CME), posterior vitreous detachment (PVD), retinal atrophy, subretinal hemorrhage, choroidal laceration, and focal neuroepithelial detachment was 36 (48.00%, 36/75), 4 (5.33%, 4/75), 4 (5.33%, 4/75), 15 (20.00%, 15/75), 8 (10.67%, 8/75), and 19 (25.33%, 19/75) eyes, respectively. In the IMH group, the number of eyes with CME and PVD was 95 (95.96%, 95/99) and 94 (94.95%, 94/99) eyes, respectively. Conclusion Compared with IMH, TMH has a larger basal diameter, a thinner CRT at the hole margin, and a higher incidence of CME, subretinal hemorrhage, focal neuroepithelial detachment, choroidal laceration, and retinal atrophy.

1.	Iwasaki M, Nakashizuka H, Tanaka K, et al. A comparative study of medium-sized macular hole surgery with inverted internal limiting membrane flap technique versus conventional peeling[J]. Retina, 2024, 44(4): 635-641. DOI: 10.1097/IAE.0000000000004022.
2.	Nene AS, Divate S, Ramteke P, et al. Modified ILM flap technique for macular hole[J/OL]. Indian J Ophthalmol, 2023, 71(10): 3425[2023-10-01]. https://pubmed.ncbi.nlm.nih.gov/37787255/. DOI: 10.4103/IJO.IJO_883_23.
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4.	Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis[J]. Arch Ophthalmol, 1988, 106(5): 629-639. DOI: 10.1001/archopht.1988.01060130683026.
5.	Gaudric A, Haouchine B, Massin P, et al. Macular hole formation: new data provided by optical coherence tomography[J]. Arch Ophthalmol, 1999, 117(6): 744-751. DOI: 10.1001/archopht.117.6.744.
6.	Chauhan DS, Antcliff RJ, Rai PA, et al. Papillofoveal traction in macular hole formation: the role of optical coherence tomography[J]. Arch Ophthalmol, 2000, 118(1): 32-38. DOI: 10.1001/archopht.118.1.32.
7.	Kishi S, Takahashi H. Three-dimensional observations of developing macular holes[J]. Am J Ophthalmol, 2000, 130(1): 65-75. DOI: 10.1016/s0002-9394(00)00383-4.
8.	Ito Y, Terasaki H, Suzuki T, et al. Mapping posterior vitreous detachment by optical coherence tomography in eyes with idiopathic macular hole[J]. Am J Ophthalmol, 2003, 135(3): 351-355. DOI: 10.1016/s0002-9394(02)01944-x.
9.	Delori F, Pomerantzeff O, Cox MS. Deformation of the globe under high-speed impact: it relation to contusion injuries[J]. Invest Ophthalmol, 1969, 8(3): 290-301.
10.	Arevalo JF, Sanchez JG, Costa RA, et al. Optical coherence tomography characteristics of full-thickness traumatic macular holes[J]. Eye (Lond), 2008, 22(11): 1436-1441. DOI: 10.1038/sj.eye.6702975.
11.	Huang J, Liu X, Wu Z, et al. Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2010, 248(8): 1071-1075. DOI: 10.1007/s00417-009-1226-z.
12.	Hirata A, Tanihara H. Ruptured internal limiting membrane associated with blunt trauma revealed by indocyanine green staining[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(6): 527-530. DOI: 10.1007/s00417-004-0875-1.
13.	Tornambe PE. Macular hole genesis: the hydration theory[J]. Retina, 2003, 23(3): 421-424. DOI: 10.1097/00006982-200306000-00028.
14.	Uchino E, Uemura A, Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography[J]. Arch Ophthalmol, 2001, 119(10): 1475-1479. DOI: 10.1001/archopht.119.10.1475.
15.	原莉莉, 韩金栋, 李筱荣. 手术与非手术治疗对外伤性黄斑裂孔愈合及视功能的影响[J]. 中华眼底病杂志, 2015, 31(1): 45-48. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.012.Yuan LL, Han JD, Li XR. Clinical analysis of 47 cases with traumatic macular hole resulted from ocular contusion[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 45-48. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.012.
16.	Chen H, Chen W, Zheng K, et al. Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography[J/OL]. Sci Rep, 2015, 5: 12343[2015-07-21]. https://pubmed.ncbi.nlm.nih.gov/26196460/. DOI: 10.1038/srep12343.

1. Iwasaki M, Nakashizuka H, Tanaka K, et al. A comparative study of medium-sized macular hole surgery with inverted internal limiting membrane flap technique versus conventional peeling[J]. Retina, 2024, 44(4): 635-641. DOI: 10.1097/IAE.0000000000004022.
2. Nene AS, Divate S, Ramteke P, et al. Modified ILM flap technique for macular hole[J/OL]. Indian J Ophthalmol, 2023, 71(10): 3425[2023-10-01]. https://pubmed.ncbi.nlm.nih.gov/37787255/. DOI: 10.4103/IJO.IJO_883_23.
3. 刘杏, 凌运兰, 李梅. 特发性黄斑裂孔的光学相干断层扫描图像特征[J]. 中华眼底病杂志, 1999, 15(4): 205. DOI: 10.3760/j.issn:1005-1015.1999.04.002.4.Liu X, Ling YL, Li M. Optical coherence tomography image features of idiopathic macular hole[J]. Chin J Ocul Fundus Dis, 1999, 15(4): 205. DOI: 10.3760/j.issn:1005-1015.1999.04.002.4.
4. Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis[J]. Arch Ophthalmol, 1988, 106(5): 629-639. DOI: 10.1001/archopht.1988.01060130683026.
5. Gaudric A, Haouchine B, Massin P, et al. Macular hole formation: new data provided by optical coherence tomography[J]. Arch Ophthalmol, 1999, 117(6): 744-751. DOI: 10.1001/archopht.117.6.744.
6. Chauhan DS, Antcliff RJ, Rai PA, et al. Papillofoveal traction in macular hole formation: the role of optical coherence tomography[J]. Arch Ophthalmol, 2000, 118(1): 32-38. DOI: 10.1001/archopht.118.1.32.
7. Kishi S, Takahashi H. Three-dimensional observations of developing macular holes[J]. Am J Ophthalmol, 2000, 130(1): 65-75. DOI: 10.1016/s0002-9394(00)00383-4.
8. Ito Y, Terasaki H, Suzuki T, et al. Mapping posterior vitreous detachment by optical coherence tomography in eyes with idiopathic macular hole[J]. Am J Ophthalmol, 2003, 135(3): 351-355. DOI: 10.1016/s0002-9394(02)01944-x.
9. Delori F, Pomerantzeff O, Cox MS. Deformation of the globe under high-speed impact: it relation to contusion injuries[J]. Invest Ophthalmol, 1969, 8(3): 290-301.
10. Arevalo JF, Sanchez JG, Costa RA, et al. Optical coherence tomography characteristics of full-thickness traumatic macular holes[J]. Eye (Lond), 2008, 22(11): 1436-1441. DOI: 10.1038/sj.eye.6702975.
11. Huang J, Liu X, Wu Z, et al. Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2010, 248(8): 1071-1075. DOI: 10.1007/s00417-009-1226-z.
12. Hirata A, Tanihara H. Ruptured internal limiting membrane associated with blunt trauma revealed by indocyanine green staining[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(6): 527-530. DOI: 10.1007/s00417-004-0875-1.
13. Tornambe PE. Macular hole genesis: the hydration theory[J]. Retina, 2003, 23(3): 421-424. DOI: 10.1097/00006982-200306000-00028.
14. Uchino E, Uemura A, Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography[J]. Arch Ophthalmol, 2001, 119(10): 1475-1479. DOI: 10.1001/archopht.119.10.1475.
15. 原莉莉, 韩金栋, 李筱荣. 手术与非手术治疗对外伤性黄斑裂孔愈合及视功能的影响[J]. 中华眼底病杂志, 2015, 31(1): 45-48. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.012.Yuan LL, Han JD, Li XR. Clinical analysis of 47 cases with traumatic macular hole resulted from ocular contusion[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 45-48. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.012.
16. Chen H, Chen W, Zheng K, et al. Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography[J/OL]. Sci Rep, 2015, 5: 12343[2015-07-21]. https://pubmed.ncbi.nlm.nih.gov/26196460/. DOI: 10.1038/srep12343.

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