[Diagnosis and surgical treatment of idiopathic macular holes]

Evaluation of diagnostical methods and pars plana vitrectomy (ppv) in surgical treatment of idiopathic macular holes.

Group of 16 patients, 15 women and 1 man, aged between 48 and 78 years, mean age 63 years. The surgical treatment--ppv were performed in all patients with macular holes stage II-IV. In all patients the following examinations were performed: distant and near visual acuity, ophthalmoscopy in Volk 60 lens, Amsler test, colour vision test with anomaloscope IF2, ultrasonic evaluation of vitreous chamber and particularly of premacular region, and electrophysiological tests-visual evoked potentials (VEP) and electroretinography (ERG). 12 patients were treated by ppv with exchange fluid-gas SF6, and in 4 patients extra adjuvant--own patient's serum was injected after earlier exchange fluid-air-gas SF6.

In 80% of cases there was an improvement of vision observed by patients, improvement of near visual acuity and reduction of metamorphopsia in Amsler test. In USG examination the reduction of macular thickening, lack of operculum and presence of complete posterior vitreous detachment in the region of macula were observed after surgery. In electrophysiological investigations there was the improvement of VEP parameters using 1/4 visual field as a stimulus. In 1 case treated with adjuvants, there was endophtalmitis with secondary retinal detachment after ppv.

Ppv in nearly all cases gave good results for patients--improvement of visual comfort and reduction of central defect of vision. It also gave good surgical--anatomical results. Using of adjuvant--own patient's serum, did not improve in particular way the functional and anatomical results of surgery.