Analysis of progression rate of idiopathic macular hole and optimal cut-off for baseline minimum linear diameter and base diameter

Abstract

Abstract This retrospective study aimed to determine the cut-off points of minimum linear diameter (MLD) and base diameter (BD) at which the progression rate of idiopathic full-thickness macular hole (MH) decreases before vitrectomy. We investigated the difference in MLD and BD between baseline and operation days in 282 eyes of 269 patients with stages 2, 3, and 4 MH using optical coherence tomography (OCT). Each difference in the OCT parameters was divided by the time interval to calculate the MH progression rate. The average time from baseline to operation was 36.02 ± 24.69 (7–197) days. MLD and BD progressed faster in stages 2 and 3 without posterior vitreous detachment (PVD) than in stage 4 with PVD (MLD: p < 0.001, p = 0.007; BD: p < 0.001, p = 0.019, respectively). The progression rate decreased as baseline MLD and BD increased (p = 0.004 and p < 0.001, respectively). For baseline MLD and BD, the optimal cut-off points where the progression rate decreased were 306.0 µm and 470.0 µm, respectively. The progression rates were significantly higher in MH with MLD < 306.0 µm and BD < 470.0 µm. Vitrectomy without delay is expected to improve the visual prognosis in these patients.