Department of Ophthalmology and Visual Sciences, University of Louisville, Kentucky, USA.
Invest Ophthalmol Vis Sci. 2011 Oct 21;52(11):8266-70. doi: 10.1167/iovs.11-8191.
To mathematically analyze and to clinically describe specific anatomic foveal configurations predisposing to the formation of macular holes in comparison with normal foveal anatomy.
In a retrospective observational case-control series, a total of 3882 optical coherence tomography (OCT) foveal thickness maps were analyzed; 96 foveal maps were identified before the formation of macular holes. Maps were analyzed using several anatomic measurements including: retinal thickness, foveal slope, and length of foveal depression. The mathematical analog of the foveal configuration was analyzed using automated symbolic regression software and the equation to describe the mathematical relationship in a 0.083 fit was derived for premacular hole foveas compared with normal age-matched foveas.
Premacular hole anatomic configuration was found to be significantly different from normal foveal anatomy for maximal slope (P < 0.05) and for central length of foveal depression (P < 0.05). The mathematical regression function followed a first-order cosine curve of level 12 complexity for normal fovea compared with a complex sine curve of level 30 complexity function for premacular hole fovea. Normal foveas had higher symmetry (0.86 ± 0.1, P = 0.03) along the midline, whereas premacular hole foveas had steeper maximal slopes (40 ± 18°, P = 0.01); 75% of these patients had similar foveal configuration in the fellow eye and 50% developed bilateral macular holes.
Premacular hole foveal configurations are significantly different from normal foveal configurations. Suspicious macular configurations are easy to recognize on OCT scans and may allow early diagnosis, follow-up, and better management of macular hole-prone patients.
通过数学分析和临床描述，比较正常黄斑解剖结构，研究特定的黄斑中心凹解剖结构，预测黄斑裂孔的形成。
本回顾性观察性病例对照研究共分析了 3882 例光学相干断层扫描（OCT）黄斑中心凹厚度图；共发现 96 例黄斑中心凹区在黄斑裂孔形成前的 OCT 图。使用视网膜厚度、黄斑中心凹斜率和黄斑中心凹凹陷长度等多种解剖学测量方法对 OCT 图进行分析。使用自动符号回归软件分析黄斑中心凹形态的数学模拟，得出黄斑裂孔前黄斑中心凹与正常年龄匹配黄斑中心凹的数学关系方程，拟合度为 0.083。
与正常黄斑中心凹相比，黄斑裂孔黄斑中心凹解剖结构在最大斜率（P < 0.05）和黄斑中心凹凹陷中央长度（P < 0.05）方面存在显著差异。正常黄斑中心凹的数学回归函数呈 12 级复杂度的一阶余弦曲线，而黄斑裂孔前黄斑中心凹的数学回归函数呈 30 级复杂度的复杂正弦曲线。正常黄斑中心凹沿中线具有更高的对称性（0.86 ± 0.1，P = 0.03），而黄斑裂孔前黄斑中心凹的最大斜率更陡峭（40 ± 18°，P = 0.01）；这些患者中有 75%的双眼具有相似的黄斑中心凹形态，50%的患者发展为双眼黄斑裂孔。
黄斑裂孔前黄斑中心凹形态与正常黄斑中心凹形态存在显著差异。OCT 扫描容易识别可疑的黄斑形态，有助于早期诊断、随访和更好地管理黄斑裂孔高危患者。
