Measuring Macular holes in three dimensions; the MAMOTH study

• Research type

  Research Study

• Full title

  Measuring Macular holes in three dimensions; the MAMOTH study

• IRAS ID

  272230

• Contact name

  David Steel

• Contact email

  david.steel@newcastle.ac.uk

• Sponsor organisation

  South Tyneside and Sunderland NHS Foundation Trust

• Duration of Study in the UK

  0 years, 11 months, 31 days

• Research summary

  Summary of Research
  Macular holes (MH) are a common and blinding condition. Patients over 60 years old are most often affected and 10% occur in both eyes. (Meuer et al. 2015) MHs are defects in the retina (the thin ‘photographic’ film at the back of the eye which converts light energy into electrical signals transmitted to our brains to enable vision) which form secondary to age-related changes in the eye’s vitreous jelly. Because the very central retina (the fovea) is affected, MHs cause profound visual deterioration.

  MH are one of the most common indications for vitrectomy, with over 3000 surgeries/year in the UK and 80,000+ globally. (Jackson et al, 2013) The optimum surgical technique and visual prognosis depends upon accurate assessment of the MH’s size and shape. (Madi et al. 2016) Optical coherence tomography (OCT) scanners measure MHs with high detail to produce magnified optical cross-sections through the retina and MHs. OCT scans take seconds to perform and are painless. Currently, MH widths are determined from scan images by clinicians using calipers in one-dimension, but this is time-consuming, subject to error and does not accurately represent the complex and variable 3-dimensional MH structure (Bannerjee et al. 2013). Misjudgement of MH size results because, for example, the true maximum MH width may lie in an oblique axis which cannot be appreciated using 1-dimensional parameters. Measurements based on 3-Dimensional parameters may be the best predictors of outcome. (Geng et al. 2017)

  We have produced a fully-automated image analysis algorithm that measures MHs in 3-dimensions using routinely acquired preoperative OCT scans and have published on the algorithm’s accuracy. (Nasrulloh et al. 2018 and Willcocks et al. 2017)

  To enable global adoption of our algorithms, aim to develop its use with all 3 of the major OCT manufacturers. We aim to perform a prospective study on approximately 20 new patients with MHs to test the validity of the algorithm in providing accurate and repeatable measurements of MH using all three manufacturers.

  Summary of Results
  The Mamoth study aimed to assess the ability of a new computer system in measuring the size of macular holes from 3 different retinal imaging machines.
  The study successfully recruited 20 patients and we have found that repeatability of the system is good for assessing the size of macular holes between scans both repeated on separate occasions and between different machines. We are hoping to make the system available for eye doctors to use to improve patient care and are in the process of conducting further studies to improve and verify the systems use. The data obtained from the Mamoth study is helping us to do this. We have also used the data to develop a new computer program that detects a specific part of the retina which we belive will be useful in predicting the results of macular hole surgery and which we have published
  https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbfBkV8STyx-2BNg3HoA191NasM0GzXDgROx2PPWQJTYTZmvb23xvkJKkQ0-2B1A1l6HcCw-2FroldzrK9G4CROdhVi8-2ByyLsyWM92SULg634hIsArxQk9F_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YL0QtWRFAGPs-2BcrC1NM65wR442aGfSnfvVPA-2F5V4N70RrOrYXqcQn7GadKblN-2FZBd67rGFSspRbAt7bU-2B5IkQ4roQfwfLh0EMqv1iZkyFIlZKJxXUKVGLst8HeyUqInt6GCY6TxNfvaWhsD7FPlbBjTpDHQSeXkuwSVdJ-2FffTg-2BBw-3D-3D&data=05%7C01%7Capprovals%40hra.nhs.uk%7C47e9a0fa283c497e19b908da973f5553%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637988595513864973%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=MOekEBlvTIC70Mfu9LKlUZuP3UgGh24zx3WhrRJSV2c%3D&reserved=0

• REC name

  Wales REC 6

• REC reference

  19/WA/0346

• Date of REC Opinion

  29 Nov 2019

• REC opinion

  Favourable Opinion