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Idiopathic Macular Hole without Vitreomacular Separation.
Angelique Chiu Ang1, Yi-Ting Hsieh1, Mei-Chi Tsui1
1Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Summary
Idiopathic full-thickness macular holes (FTMH) without vitreomacular separation (VMS) are uncommon, often smaller, and show higher spontaneous closure rates. Treatment outcomes are comparable to FTMH with VMS.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Diseases
Background:
- Idiopathic full-thickness macular hole (FTMH) is a common retinal condition.
- Vitreomacular separation (VMS) is typically observed in FTMH.
- Understanding FTMH without VMS is crucial for diagnosis and treatment.
Purpose of the Study:
- To investigate the clinical features of idiopathic FTMH without VMS.
- To evaluate the treatment outcomes for FTMH without VMS.
- To compare FTMH without VMS to those with VMS.
Main Methods:
- Retrospective analysis of 124 consecutive idiopathic FTMH cases.
- Classification into groups with and without VMS based on OCT imaging.
- Comparison of pre- and postoperative ophthalmic examinations and OCT findings.
Main Results:
- 12.1% of FTMH cases lacked VMS, characterized by an attached posterior hyaloid.
- FTMH without VMS had smaller macular hole size (276.06 μm vs. 492.83 μm).
- Higher incidence of lamellar hole-associated epiretinal proliferation (86.7%) and spontaneous closure (13.3%) in the no-VMS group.
Conclusions:
- FTMH without VMS is a distinct entity, often associated with attached posterior hyaloid and tangential traction.
- These holes are typically smaller with a higher spontaneous closure rate.
- Surgical outcomes for FTMH without VMS are similar to those with VMS.
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