The care pathway for macular holes
When a patient has been diagnosed as having a macular hole they will have degraded eyesight in that eye.
A retinal eye surgeon will usually operate to close the macular hole to prevent further deterioration of
eyesight and possibly allow for visual imporovement. Intogral software applied to OCT images displays
accurate size parameters to be used by retinal eye surgeons for improved management planning, outcome
prediction and communication with patients.
Almost all macular holes are successfully closed, if there is visual improvement this can help
The current care pathway is broadly as follows:
A patient, with vision difficulty in an eye, visits a GP, an optometrist or sometimes an emergency eye
hospital, where it is identified that that there may be a problem that needs specialist attention. Upon
referral to an ophthalmologist the patient’s eye is scanned using an OCT scanner which produces 2D
scans. If a macular hole is confirmed, the patient is referred to a retinal eye surgeon who will repeat the
OCT scan. Even though the macular hole is asymmetric in 3D, looking at the 2D horizontal line scans the surgeon
must judge which slice has the minimum linear diameter (MLD). The measurement is important because research suggests
that the MLD correlates with the final patient outcome and possibly the degree of visual improvement.