Clinical and morphological comparisons of idiopathic macular holes between stage 3 and stage 4
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To compare clinical and morphological differences in idiopathic macular holes (IMHs) between stage 3 and stage 4.
In this retrospective cross-sectional observational study, patients with stage 3 and stage 4 IMHs based on Gass’s classification in 1988 were enrolled. Horizontally and vertically, optical coherence tomography (OCT)-based parameters including minimum linear diameter (MLD), basal diameter (BD), and macular hole height (H) were measured; fluid cuff (FC), diameter hole index (DHI), macular hole index (MHI), traction hole index (THI), and hole form factor (HFF) were calculated. Afterwards, stage 3 IMHs smaller than 400 μm were excluded according to Gass’s classification in 1995. Clinical features, such as age, duration of symptoms, and baseline best-corrected visual acuity (BCVA), and OCT parameters were compared respectively between two stages based on both classifications.
Given classification of 1988, stage 3 IMHs had significantly shorter duration of symptoms (P = 0.020) and smaller horizontal BD (P = 0.041). Horizontally and vertically, MLD (P = 0.001, 0.004 respectively), DHI (P = 0.032, 0.021 respectively), and HFF (P = 0.032, 0.017 respectively) were significantly smaller and THI (P = 0.011, 0.020 respectively) was significantly larger in stage 3 holes. Clinical features like age and baseline BCVA showed no significant differences. When staged by classification of 1995, IMHs of the two stages shared similar features.
Stage 3 IMHs, instead of owning shorter duration of symptoms and smaller diameters, share similar clinical and morphological features with stage 4 IMHs according to Gass’s classification in 1995, which excludes IMHs smaller than 400 μm from stage 3 compared to his 1988 version.
KeywordsIdiopathic macular hole Stage Optical coherence tomography Morphology
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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