OBJECTIVE: To present the characteristics and outcomes of macular holes (MHs) that arise in eyes that have been treated for retinal detachment (RD). DESIGN: Retrospective, interventional, consecutive case series. PARTICIPANTS: We studied 18 eyes that developed a MH following RD repair. METHODS: We report the demographic and clinical characteristics, MH closure rates, and best corrected visual acuity (BCVA) following MH repair. RESULTS: We detected 18 full-thickness MHs in 985 eyes. In 14 of 18, the original RD involved the macula, and in 16 of 18, the BCVA was 20/200 or worse. Of the RDs, 8 of 18 required multiple procedures to achieve reattachment. Post-RD BCVA was 20/200 or worse in 15 of 18 patients. The median time to MH diagnosis after RD repair was 1 month (range, 2 days to 53 months), and from MH diagnosis to MH repair, the median time was 1.75 months (range, 3 weeks to 8 months). Of 16 eyes (89%) that underwent surgical repair of the MH, 14 achieved MH closure, 1 requiring multiple pars plana vitrectomy, and 11 saw at least 1 Snellen line of improvement (median, 1; range, 1 to 6); 2 lost vision (1 and 2 Snellen lines, respectively); and 3 remained unchanged at a median follow-up of 3 months (range, 1 month to 25 months). Of the 18 patients, 6 had at least 20/80 BCVA at last follow-up. CONCLUSIONS: MHs following RDs (incidence 1.9%) are likely to be macula-off RDs requiring multiple interventions for RD repair. Post-MH-repair closure rates are similar to the rates for idiopathic MHs. BCVA outcomes are moderate and are dependent on impairment post-RD repair. The findings suggest other pathogenic mechanisms besides vitreofoveal traction may be leading to these MHs.
OBJECTIVE: To present the characteristics and outcomes of macular holes (MHs) that arise in eyes that have been treated for retinal detachment (RD). DESIGN: Retrospective, interventional, consecutive case series. PARTICIPANTS: We studied 18 eyes that developed a MH following RD repair. METHODS: We report the demographic and clinical characteristics, MH closure rates, and best corrected visual acuity (BCVA) following MH repair. RESULTS: We detected 18 full-thickness MHs in 985 eyes. In 14 of 18, the original RD involved the macula, and in 16 of 18, the BCVA was 20/200 or worse. Of the RDs, 8 of 18 required multiple procedures to achieve reattachment. Post-RD BCVA was 20/200 or worse in 15 of 18 patients. The median time to MH diagnosis after RD repair was 1 month (range, 2 days to 53 months), and from MH diagnosis to MH repair, the median time was 1.75 months (range, 3 weeks to 8 months). Of 16 eyes (89%) that underwent surgical repair of the MH, 14 achieved MH closure, 1 requiring multiple pars plana vitrectomy, and 11 saw at least 1 Snellen line of improvement (median, 1; range, 1 to 6); 2 lost vision (1 and 2 Snellen lines, respectively); and 3 remained unchanged at a median follow-up of 3 months (range, 1 month to 25 months). Of the 18 patients, 6 had at least 20/80 BCVA at last follow-up. CONCLUSIONS: MHs following RDs (incidence 1.9%) are likely to be macula-off RDs requiring multiple interventions for RD repair. Post-MH-repair closure rates are similar to the rates for idiopathic MHs. BCVA outcomes are moderate and are dependent on impairment post-RD repair. The findings suggest other pathogenic mechanisms besides vitreofoveal traction may be leading to these MHs.
Authors: Ki Yup Nam; Hyun Kyung Cho; Tae Seen Kang; Ji Hye Kim; Bum Jun Kim; Yong Seop Han Journal: Medicine (Baltimore) Date: 2020-09-04 Impact factor: 1.889
Authors: Carlos A Medina; Angelica G Ortiz; Nidhi Relhan; William E Smiddy; Justin H Townsend; Harry W Flynn Journal: Retina Date: 2017-06 Impact factor: 4.256