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Macular microholes
Geoffrey G Emerson1, Gregory R Spencer, Michael L Klein
1Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Boulevard, Portland, OR 97239-4197, USA.
Purpose:
To describe the clinical features and natural course of microholes of the macula.
Methods:
We reviewed the charts of 31 patients (35 eyes) with punctate foveal defects, or "microholes," of the macula. Patients were seen between 1980 and 2005 at a tertiary referral center. Clinical, photographic, and optical coherence tomography findings were reviewed.
Results:
All eyes had one or more well defined, punctate foveal lesions 35 microm to 150 microm in size. There was no gender predilection, and patient ages ranged from 6 years to 69 years. Visual acuity was > or =20/40 in 29 of 35 eyes. None of the eyes had foveal transmission defects shown by fluorescein angiography. A defect in the outer retina was demonstrated in five of seven patients who underwent optical coherence tomography. The lesions were nonprogressive, with no patients developing stage 3 or 4 macular holes.
Conclusion:
Macular microholes are small lamellar defects in the outer retina or retinal pigment epithelium that occur through a variety of mechanisms, including spontaneous vitreoretinal interface changes, trauma, phototoxicity, and other unrecognized causes. The condition is nonprogressive, occurs in patients of all ages, and is compatible with good visual acuity.
Insights
Macular microholes are small retinal defects that do not worsen over time and are compatible with good visual acuity. These foveal lesions, often detected via optical coherence tomography, do not typically progress to full macular holes.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Macular Disorders
Background:
- Macular microholes are characterized by punctate foveal defects.
- Their clinical features and natural course require detailed description.
Purpose of the Study:
- To describe the clinical features of macular microholes.
- To elucidate the natural course of these foveal lesions.
Main Methods:
- Retrospective chart review of 31 patients (35 eyes) with macular microholes.
- Analysis of clinical, photographic, and optical coherence tomography (OCT) findings.
- Data collected from a tertiary referral center between 1980 and 2005.
Main Results:
- Lesions were well-defined, punctate foveal defects (35-150 micrometers).
- Good visual acuity (≥20/40) was observed in most patients (29/35 eyes).
- Optical coherence tomography revealed outer retinal defects in some cases; lesions were nonprogressive.
Conclusions:
- Macular microholes are small, lamellar outer retinal defects with varied etiologies.
- These defects are nonprogressive, affect all age groups, and are compatible with good visual acuity.
- Macular microholes do not typically progress to full-stage macular holes.
