T Hikichi1, A Yoshida, J Akiba, C L Trempe. 1. Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Abstract
AIMS: A study was carried out to ascertain the natural outcome of each stage of idiopathic macular hole. METHODS: One hundred and fifty four eyes with different stages of idiopathic macular holes were retrospectively studied: stage 1 (40 eyes), 2 (25 eyes), 3 (58 eyes), and 4 (31 eyes). RESULTS: Of 27 of 40 eyes with a stage 1 lesion with posterior vitreous attachment to the macula initially, nine (33%) eyes developed a full thickness macular hole. No stage 1 lesions with posterior vitreous separation from the macula initially progressed to full thickness holes. Twenty one (84%) of 25 eyes with a stage 2 lesion, 32 (55%) of 58 eyes with a stage 3 lesion, and five (16%) of 31 eyes with a stage 4 lesion underwent macular hole enlargement during the median follow up period of 3 years. Visual acuity decreased two or more lines of Snellen equivalent during the follow up period in 12 (30%) eyes with a stage 1 lesion, 17 (68%) eyes with a stage 2 lesion, 17 (29%) eyes with a stage 3 lesion, and four (13%) eyes with a stage 4 lesion. The percentage was significantly higher in eyes with stage 2 lesions than the other stages (p < 0.01). CONCLUSION: The results suggest that the different stages of idiopathic macular holes have different natural outcomes, and the management depends on the stage at presentation.
AIMS: A study was carried out to ascertain the natural outcome of each stage of idiopathic macular hole. METHODS: One hundred and fifty four eyes with different stages of idiopathic macular holes were retrospectively studied: stage 1 (40 eyes), 2 (25 eyes), 3 (58 eyes), and 4 (31 eyes). RESULTS: Of 27 of 40 eyes with a stage 1 lesion with posterior vitreous attachment to the macula initially, nine (33%) eyes developed a full thickness macular hole. No stage 1 lesions with posterior vitreous separation from the macula initially progressed to full thickness holes. Twenty one (84%) of 25 eyes with a stage 2 lesion, 32 (55%) of 58 eyes with a stage 3 lesion, and five (16%) of 31 eyes with a stage 4 lesion underwent macular hole enlargement during the median follow up period of 3 years. Visual acuity decreased two or more lines of Snellen equivalent during the follow up period in 12 (30%) eyes with a stage 1 lesion, 17 (68%) eyes with a stage 2 lesion, 17 (29%) eyes with a stage 3 lesion, and four (13%) eyes with a stage 4 lesion. The percentage was significantly higher in eyes with stage 2 lesions than the other stages (p < 0.01). CONCLUSION: The results suggest that the different stages of idiopathic macular holes have different natural outcomes, and the management depends on the stage at presentation.
Authors: B F Jost; W L Hutton; D G Fuller; A Vaiser; W B Snyder; G E Fish; R Spencer; D G Birch Journal: Ophthalmology Date: 1990-07 Impact factor: 12.079