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Background  To determine whether preoperative hole diameter ratio (HDR) is a predictive factor for postoperative anatomical outcome for stage III or IV idiopathic macular holes (IMHs).    Methods  One-hundred and one eyes with stage III or IV IMH were included in this retrospective case series study. All cases were treated with vitrectomy combined with internal limiting membrane (ILM) peeling and room air tamponade. The macular hole (MH) minimum and maximum diameter was measured on preoperative optical coherence tomography (OCT) images. The HDR was defined as the minimum to maximum diameter ratio.    Results  Eighty-one eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The preoperative minimal diameter (703.6 ± 116.1 μm vs. 597.6 ± 120.1 μm,  P  < 0.01) and HDR (0.6 ± 0.1 vs. 0.5 ± 0.1,  P  = 0.01) were both significantly smaller in postoperative closed eyes. The closure rate of IMHs with HDR < 0.6 was significantly higher than those with HDR ≥ 0.6 (90.2% vs. 65.0% P  = 0.002) .    Conclusions  Preoperative HDR < 0.6 is predictive for a good postoperative anatomical outcome in stage III or IV IMHs.

Hole diameter ratio for prediction of anatomical outcomes in stage III or IV idiopathic macular holes