title: The Case Mix of Patients Presenting with Full-Thickness Macular Holes and Progression before Surgery: Implications for Optimum Management.
abstract: OBJECTIVE
  Analysis of pre-operative spectral domain optical coherence tomography (SD-OCT) characteristics of full-thickness macular holes (FTMH) and effect on optimum management.
  
  
  METHODS
  We retrospectively reviewed SD-OCT characteristics of a consecutive cohort of patients waitlisted for FTMH surgery and categorized them by current evidence-based treatments.
  
  
  RESULTS
  Out of the 106 holes analysed, 36 were small, 40 medium and 30 large. Initially, 33 holes had vitreomacular adhesion (VMA). 41 holes were analysed for change in characteristics with a median duration of 8 weeks between the scans. The number of small or medium holes decreased from 20 to 6 and that of large holes doubled. The number of holes with VMA halved. Smaller hole size (p = 0.014) and being phakic (p = 0.048) were associated with a larger increase in size. The strongest predictor of hole progression into a different surgical management category was the presence of VMA.
  
  
  CONCLUSIONS
  FTMH characteristics can change significantly pre-operatively and affect optimal treatment choice.
authors.affiliation: Sunderland Eye Infirmary, Sunderland, UK.
authors.forename: Haifa A
authors.initials: HA
authors.lastname: Madi
authors.forename: Christiana
authors.initials: C
authors.lastname: Dinah
authors.forename: Jon
authors.initials: J
authors.lastname: Rees
authors.forename: David H W
authors.initials: DH
authors.lastname: Steel
mesh_terms: D000368:Aged; D003953:Diagnosis-Related Groups; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D057234:Preoperative Period; D012160:Retina / Q000378:metabolism; D012167:Retinal Perforations / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism; D014850:Waiting Lists