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Helmy YAH, ElNahry AG, Zein OE, Charbaji S, Yonekawa Y, Mansour HA, Serhan HA, Al-Nawaflh M, Parodi MB, Williams BK, Mansour AM. Pediatric and Adolescent Traumatic Macular Hole: A Systematic Review. Am J Ophthalmol 2024; 265:165-175. [PMID: 38710352 DOI: 10.1016/j.ajo.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE The optimal management of pediatric traumatic macular holes (TMH) is unclear from lack of prospective randomized trials. The literature is divided into early (≤1month post-trauma), delayed (>1 month) pars plana vitrectomy (PPV), and observation. Our aim is to find which group can achieve best-superior spectacle corrected visual acuity (VA), visual gain, and time for hole closure. DESIGN Systematic review. METHODS This systematic review was registered with PROSPERO (ID:CRD42022383134). The databases searched from inception until July 31, 2023, were MEDLINE OVID, Scopus, Web of Science, Embase, and Google Scholar. The articles were screened for title and abstract then for full text. Risk of bias was also assessed. Three outcome measures were analyzed: final VA, visual gain, and time to closure of macular hole (MH). MH size was divided into small (≤250 µm), medium (>250-500 µm), and large (>500 µm). RESULTS Ninety eight (98) studies with 234 patients in the PPV group and 87 patients in the observation group were included in the review. Final VA (logarithm of the minimum angle of resolution) and visual gain were respectively in PPV vs observation groups: (1) small MH 0.37 ± 0.52 vs 0.42 ± 0.56 (P = .484) and -0.96 ± 0.83 vs -0.49 ± 0.40 (P = .005); (2) medium MH 0.58 ± 0.39 vs 0.34 ± 0.34 (P = .06) and -0.36 ± 0.42 vs -0.74 ± 0.44 (P < .001); (3) large MH 0.62 ± 0.42 vs 0.59 ± 0.35 (P = .337) and -0.31 ± 0.48 vs -0.62 ± 0.37 (P = .11). Small TMH had comparable closure time: 3.21 ± 2.52 months vs 3.49 ± 4.43 (P = .954) in the PPV and observation groups. Early and late PPV yielded comparable final VA 0.67 ± 0.66 vs 0.54 ± 0.35 (P = .576) and visual gain -0.58 ± 0.69 vs -0.49 ± 0.48 (P = .242) in the PPV and observation groups. CONCLUSIONS PPV was very effective in closing TMH and VA gain in children throughout a wide range of hole size. Early and delayed PPV yielded similar anatomic and visual results. Observation and PPV yielded comparable final VA and closure time. Clinicians can choose either early PPV or delayed PPV when healing biomarkers are absent on periodic optical coherence tomography.
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Affiliation(s)
- Youssef A H Helmy
- From the Department of Ophthalmology, Stoke Mandeville Hospital, Buckinghamshire NHS Healthcare Trust (Y.A.H.L.), Aylesbury, UK; Department of Ophthalmology, Faculty of Medicine, Cairo University (Y.A.H.L., A.G.E.), Cairo, Egypt
| | - Ayman G ElNahry
- Department of Ophthalmology, Faculty of Medicine, Cairo University (Y.A.H.L., A.G.E.), Cairo, Egypt; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami (A.G.E., B.K.W.), Coral Gables, Florida, USA
| | - Ola El Zein
- Saab Medical Library, American University of Beirut (O.E.Z.), Beirut, Lebanon
| | | | - Yoshihiro Yonekawa
- Retina Service, Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University (Y.Y., H.A.M.), Philadelphia, Pennsylvania, USA
| | - Hana A Mansour
- Retina Service, Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University (Y.Y., H.A.M.), Philadelphia, Pennsylvania, USA
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporations (H.A.S.), Doha, Qatar
| | - Mutaz Al-Nawaflh
- Department of Ophthalmology, Emory Eye Center, Emory University (M.A.-N.), Atlanta, GA, USA; Division of Ophthalmology, King Hussein Hospital, Jordanian Royal Medical Services (M.A.-N.), Amman, Jordan
| | - Maurizio Battaglia Parodi
- Department of Ophthalmology, Vita-Salute San Raffaele University, IRCCS Istituto Scientifico San Raffaele (M.B.P.), Milan, Italy
| | - Basil K Williams
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami (A.G.E., B.K.W.), Coral Gables, Florida, USA
| | - Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut (A.M.M.), Beirut, Lebanon.
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Cakir B, Hoyek S, Parikh AA, Patel NA. Pediatric Traumatic Macular Hole-A Review. Int Ophthalmol Clin 2024; 64:137-148. [PMID: 38525987 DOI: 10.1097/iio.0000000000000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
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Yang Q, Huang X, Peng R, Li R, Xu G, Wang L, Chang Q. CORRELATIONS BETWEEN SUSPENDED HYPERREFLECTIVE MATERIAL WITH THE MACULAR MICROSTRUCTURE AND SPONTANEOUS CLOSURE OF FULL-THICKNESS MACULAR HOLES. Retina 2024; 44:237-245. [PMID: 37756656 PMCID: PMC10807745 DOI: 10.1097/iae.0000000000003943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
PURPOSE To investigate the characteristics of spontaneously closed full-thickness macular holes (FTMHs) and to seek potential predictors for the spontaneous closure of FTMHs. METHODS In this retrospective cohort study, the clinical data and optical coherence tomography images were reviewed from 19 eyes with spontaneously closed FTMHs (spontaneous closure group) and 37 control eyes with FTMHs that were delayed for nonmedical reasons, but ultimately required surgery (control group). The term, suspended hyperreflective material, was defined as hyperreflective material suspended within the FTMHs observed via optical coherence tomography; the presence of suspended hyperreflective material was evaluated in these eyes. RESULTS The median time from diagnosis to spontaneous closure of the FTMHs was 13.7 (range, 2.4-32.4) weeks in the spontaneous closure group. The mean diameter of FTMHs in the spontaneous closure group was significantly smaller than that in the control group (191.68 ± 70.57 vs. 401.68 ± 162.19 µ m, P < 0.0001). The incidence of vitreomacular traction was higher in the spontaneous closure group compared with the control group (9/19 vs. 5/37, P = 0.009, odds ratio [95% confidence interval], 5.76 [1.56-21.21]); in seven of the nine eyes with vitreomacular traction from the spontaneous closure group, spontaneous vitreomacular traction separation and subsequent FTMH closure was observed. Suspended hyperreflective material was observed in nine eyes (47%) from the spontaneous closure group and three eyes (8%) from the control group ( P = 0.001, odds ratio [95% confidence interval], 10.20 [2.31‒45.02]). CONCLUSION Smaller diameters, vitreomacular traction, and presence of suspended hyperreflective material may be suggestive of the potential for spontaneous closure of FTMHs.
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Affiliation(s)
- Qian Yang
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; and
| | - Xin Huang
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; and
| | - Rui Peng
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; and
| | - Ruiwen Li
- Department of Nursing, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; and
| | - Ling Wang
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; and
| | - Qing Chang
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; and
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Zhou Q, Feng H, Lv H, Fu Z, Xue Y, Ye H. Vitrectomy vs. Spontaneous Closure for Traumatic Macular Hole: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:735968. [PMID: 35004717 PMCID: PMC8732763 DOI: 10.3389/fmed.2021.735968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This systematic review and meta-analysis aimed to determine the traumatic macular hole (TMH) closure rate and visual acuity (VA) improvement rate by comparing two treatment methods for TMH: vitrectomy and observation for spontaneous closure. Methods: PubMed, Cochrane, Web of Science Library, Embase, CNKI, Wanfang, VIP, and Sino Med were systematically searched from their inception to June 10, 2021. Studies in the surgery group (n = 32) and studies in the observation group (n = 12) were meta-analyzed. The primary outcomes were the TMH closure and VA improvement rates in the surgery and observation groups. The secondary outcomes were best-corrected visual acuity (BCVA) improvement in the surgery group. Stata software (version 15.1) was used for the analyses. Results: Thirty-six studies that included 1,009 eyes were selected for this meta-analysis, among which 33 were retrospective studies and 3 were prospective studies. The meta-analysis showed that the random-model pooled event rate for TMH closure was 0.37 (95% confidence interval [CI], 0.26-0.48) in the observation group, while it was 0.9 (95% CI, 0.85-0.94) in the surgery group. The fixed-model pooled event rate for VA improvement was 0.39 (95% CI, 0.33-0.45) in the observation group, while the random-model pooled event rate of VA improvement for the surgery group was 0.72 (95% CI, 0.63-0.80). The pooled event rate for BCVA improvement in the surgery group was 0.39 (95% CI, 0.33-0.46). Conclusions: This meta-analysis suggests that TMH hole closure and VA improvement rates in the surgery group were significantly higher than those in the observation group. Vitrectomy is an effective method for treating TMH. However, further randomized controlled trials (RCTs) are required to evaluate the efficacy and safety of surgery and observation for TMH treatment. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42021276684.
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Affiliation(s)
- Qi Zhou
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Ophthalmology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Haoyue Feng
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Ophthalmology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongbin Lv
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhongmei Fu
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Ophthalmology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuyu Xue
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Ophthalmology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hejiang Ye
- Department of Ophthalmology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Sheth JU, Weng C, Singh R, Khatri M, Saurabh K, Chawla S, Rajendran A, Narayanan R. Vitreoretinal Society of India practice pattern survey 2020: Surgical retina. Indian J Ophthalmol 2021; 69:1442-1449. [PMID: 34011717 PMCID: PMC8302326 DOI: 10.4103/ijo.ijo_2877_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose: To present the outcomes of the Vitreo-retinal Society of India (VRSI) Practice Pattern Survey 2020 in surgical retina. Methods: An online survey of members of VRSI was conducted in April 2020 regarding their practice patterns on varied medical and surgical retina topics concerning imaging and management approach. The results were evaluated by two independent experts in this field and compared with the evidence and other practice patterns in the world. Results: A total of 107 VRSI members participated in the online survey. Responses were obtained on management of wide-ranging surgical retina topics such as diabetic retinopathy, retinal detachments, Macular Hole, and Epiretinal membranes. Participants were also surveyed regarding their attitudes and perceptions about microscopes with the heads-up display system. Each of the survey question responses were then compared to contemporary literature, including evidence-based guidelines, randomized controlled trials, real-world evidence, and analogous international surveys. Comprehensive analysis related to this has been put forward in the article. Conclusion: This survey represents the contemporary practice patterns among vitreoretinal specialists in India. The survey results are vital for fellow practitioners to understand the “standard of care” practice in surgical retina. This will guide them to devise the best possible individualized treatment strategy for most favorable clinical outcomes.
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Affiliation(s)
- Jay U Sheth
- Department of Vitreoretinal Services, Surya Eye Institute and Research Center, Mumbai, Maharashtra, India
| | - Christina Weng
- Associate Professor, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Rishi Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Manoj Khatri
- Department of Vitreoretina, Eydox Eye Hospital and Rajan Eye Care Hospital, Chennai, Tamil Nadu, India
| | - Kumar Saurabh
- Department of Vitreo Retina, Kamalnayan Bajaj Sankara Nethralaya, Kolkata, West Bengal, India
| | - Shobhit Chawla
- Medical Director, Prakash Netra Kendr, Lucknow, Uttar Pradeshl Vitreoretinal Society of India, Chennai, Tamil Nadu, India
| | - Anand Rajendran
- Vitreoretinal Society of India; Retina-Vitreous Services, Aravind Eye Hospital, Chennai, Tamil Nadu, India
| | - Raja Narayanan
- Vitreoretinal Society of India, Chennai, Tamil Nadu; Suven Clinical Research Center, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Uwaydat SH, Mansour A, Ascaso FJ, Parodi MB, Foster R, Smiddy WE, Schwartz SG, Charbaji A, Belotto S, Jürgens I, Mateo J, Ellabban AA, Wu L, Figueroa M, Olivier Pascual N, Lima LH, Alsakran WA, Caliskan Kadayifcilar S, Sinawat S, Assi A, Mansour HA, Casella AM, Navea A, Neila ER, Saatci AO, Govindahari V, Esteban Floria O, Agarwal K, Bakkali El Bakkali I, Alaman AS, Larripa SF, Rey A, Pera P, Bruix L, Lopez-Guajardo L, Pérez-Salvador E, Lara Medina FJ, Hrisomalos FN, Chhablani J, Arevalo JF. Clinical characteristics of full thickness macular holes that closed without surgery. Br J Ophthalmol 2021; 106:1463-1468. [PMID: 33926863 DOI: 10.1136/bjophthalmol-2021-319001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/23/2021] [Accepted: 04/16/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To ascertain the anatomic factors that help achieve non-surgical sealing in full thickness macular hole (FTMH). METHODS Retrospective collaborative study of FTMH that closed without surgical intervention. RESULTS A total of 78 patients (mean age 57.9 years) included 18 patients with blunt ocular trauma, 18 patients that received topical or intravitreal therapies and 42 patients with idiopathic FTMH. Mean±SD of the initial corrected visual acuity (VA) in logMAR improved from 0.65±0.54 to 0.34±0.45 (p<0.001) at a mean follow-up of 33.8±37.1 months. FTMH reopened in seven eyes (9.0%) after a mean of 8.6 months. Vitreomacular traction was noted in 12 eyes (15.8%), perifoveal posterior vitreous detachment in 42 (53.8%), foveal epiretinal membrane in 10 (12.8%), cystoid macular oedema (CME) in 49 (62.8%) and subretinal fluid (SRF) in 20 (25.6%). By multivariate analysis, initial VA correlated to the height (p<0.001) and narrowest diameter of the hole (p<0.001) while final VA correlated to the basal diameter (p<0.001). Time for closure of FTMH (median 2.8 months) correlated to the narrowest diameter (p<0.001) and the presence of SRF (p=0.001). Mean time for closure (in months) was 1.6 for eyes with trauma, 4.3 for eyes without trauma but with therapy for CME, 4.4 for eyes without trauma and without therapy in less than 200 µm in size and 24.7 for more than 200 µm. CONCLUSION Our data suggest an observation period in new onset FTMH for non-surgical closure, in the setting of trauma, treatment of CME and size <200 µm.
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Affiliation(s)
- Sami H Uwaydat
- Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ahmad Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon .,Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Francisco J Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.,Department of Ophthalmology, University of Zaragoza, Zaragoza, Spain
| | | | - Robert Foster
- Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | - Stephen G Schwartz
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, Florida, USA
| | - Abdulrazzak Charbaji
- Research and Applied Statistics, Lebanese American University, Beirut, Lebanon.,Research and Applied Statistics, CHARBAJI Consultants, Beirut, Lebanon
| | - Silvana Belotto
- Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
| | - Ignasi Jürgens
- Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
| | - Javier Mateo
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Abdallah A Ellabban
- Department of Ophthalmology, Hull University Teaching Hospitals, Hull, Yorkshire, UK.,Department of Ophthalmology, Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Lihteh Wu
- Department of Ophthalmology, Apdo 144-1225 Plaza Mayor, San Jose, Costa Rica
| | - Marta Figueroa
- Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Luiz H Lima
- Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Wael A Alsakran
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Suthasinee Sinawat
- Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Alexandre Assi
- Department of Ophthalmology, Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon
| | - Hana A Mansour
- Ophthalmology, American University of Beirut, Beirut, Lebanon
| | | | - Amparo Navea
- Department of Ophthalmology, Instituto de la Retina, Valencia, Spain
| | | | - A Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | | | - Olivia Esteban Floria
- Ophthalmology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain.,Department of Ophthalmology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
| | - Komal Agarwal
- Department of Ophthalmology, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | | | | | | | - Amanda Rey
- Department of Ophthalmology, Hospital Clinic, Barcelona, Spain
| | - Patricia Pera
- Department of Ophthalmology, Institut Català de Retina SL, Barcelona, Spain
| | - Lluís Bruix
- Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
| | | | | | | | - Frank N Hrisomalos
- Department of Ophthalmology, Indiana University, Indianapolis, Indiana, USA
| | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
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Macular holes following vitrectomy for rhegmatogenous retinal detachment: epiretinal proliferation and spontaneous closure of macular holes. Graefes Arch Clin Exp Ophthalmol 2021; 259:2235-2241. [PMID: 33880629 DOI: 10.1007/s00417-021-05183-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/20/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To describe the characteristics and management of full-thickness macular holes (MHs) that develop after pars plana vitrectomy for rhegmatogenous retinal detachment (RD). METHODS Retrospective, interventional, consecutive case series. Patients who developed secondary full-thickness MHs after prior pars plana vitrectomy for RD over a 6-year period were included. The main outcome measures included optical coherence tomography (OCT) findings and the clinical course of full-thickness MHs. RESULTS A total of 11 eyes of 11 consecutive patients were included in the study. The mean age of the patients was 58.8 years (range, 47-70 years). The median time between RD repair and MH diagnosis was 36 months (range, 1 month-11 years). The fovea was attached to 10 eyes (91%) at the time of RD repair. OCT demonstrated epiretinal proliferation (EP) at the hole margin in 10 eyes (91%). MH spontaneously closed in 7 eyes (63%) but reopened in 5 eyes. A total of 7 eyes (63%) required a vitrectomy to repair the MHs. All MHs were closed at the last follow-up visit. CONCLUSION Full-thickness MHs after pars plana vitrectomy for RD have features that are distinct from that of typical idiopathic MH. The presence of EPs is common, and MHs are prone to spontaneous closure and reopening. These findings suggest that EP may be associated with spontaneous hole closure and that long-term follow-up is necessary even if the MHs close spontaneously.
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