title: Predicting macular hole closure with ocriplasmin based on spectral domain optical coherence tomography.
abstract: PurposeTo assess the preoperative features of patients with idiopathic macular hole (IMH) and vitreomacular adhesion (VMA) treated with ocriplasmin (OCP) that can predict successful closure.MethodData were prospectively collected on all patients with IMH treated with OCP in three British ophthalmic centres. Several preoperative variables were recorded including the IMH base diameter (BD), minimum linear diameter (MLD), and VMA width measured on spectral domain optical coherence tomography. Several other IMH indices were derived including a 'width factor', defined as the BD minus the MLD in μm. The occurrence of VMA release and hole closure were used as the main outcome measures.ResultsThirty-three patients in total with IMH were treated with OCP. Two patients developed rhegmatogenous retinal detachment and were excluded. The mean age of the remaining 31 patients was 71 years, and 71% were female. VMA release occurred in 19 of the 31 (61%) patients and macular hole closure in 11 (35%). Width factor was the most predictive feature for closure on multivariate analysis. The deviance R(2) was 67% (P<0.001). An IMH with a width factor of <60 μm had a 95% certainty of closure, whereas if >290 μm then there was less than a 5% chance of closure. Neither VMA width nor MLD alone was associated with VMA release or closure.ConclusionsPatients with macular holes where the BD was close in size to the MLD had an improved probability of closure than holes with wider base configurations.
authors.affiliation: Sunderland Eye Infirmary, Sunderland, UK.|Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: D H W
authors.initials: DH
authors.lastname: Steel
authors.affiliation: Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
authors.forename: C
authors.initials: C
authors.lastname: Parkes
authors.affiliation: Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
authors.forename: V T
authors.initials: VT
authors.lastname: Papastavrou
authors.affiliation: School of Mathematics and Statistics, Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Avery
authors.affiliation: Ophthalmology Department, James Cook University Hospital, Middlesborough, UK.
authors.forename: I A
authors.initials: IA
authors.lastname: El-Ghrably
authors.affiliation: Sunderland Eye Infirmary, Sunderland, UK.
authors.forename: M S
authors.initials: MS
authors.lastname: Habib
authors.affiliation: Sunderland Eye Infirmary, Sunderland, UK.
authors.forename: M T
authors.initials: MT
authors.lastname: Sandinha
authors.affiliation: Sunderland Eye Infirmary, Sunderland, UK.
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.affiliation: Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
authors.forename: K P
authors.initials: KP
authors.lastname: Stannard
authors.affiliation: Ophthalmology Department, James Cook University Hospital, Middlesborough, UK.
authors.forename: D
authors.initials: D
authors.lastname: Vaideanu-Collins
authors.affiliation: Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Hillier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000627:therapeutic use*; D011446:Prospective Studies; D012160:Retina / Q000187:drug effects; D012167:Retinal Perforations / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D000267:Tissue Adhesions / Q000188:drug therapy / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000187:drug effects
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin