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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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FULL-THICKNESS MACULAR HOLE CLOSURE WITH TOPICAL MEDICAL THERAPY.

Jessie Wang1, Sarah H Rodriguez1, Jason Xiao1

  • 1Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, Illinois.

Retina (Philadelphia, Pa.)
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Summary

Topical therapy achieved a 36.7% closure rate for full-thickness macular holes (FTMH). Smaller hole size and absence of vitreomacular traction (VMT) improved closure odds, indicating a potential non-surgical treatment option.

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Medical Therapy

Background:

  • Full-thickness macular holes (FTMH) are a significant cause of vision impairment.
  • Surgical intervention, primarily pars plana vitrectomy (PPV), is the standard treatment for FTMH.
  • Non-surgical management options for FTMH are limited, necessitating further research.

Purpose of the Study:

  • To evaluate the efficacy and clinical characteristics of achieving FTMH closure using topical therapy.
  • To identify factors influencing successful FTMH closure with non-surgical treatment.

Main Methods:

  • A retrospective case series was conducted on 49 patients diagnosed with FTMH between 2017 and 2022.
  • Patients were treated with a combination of steroid, carbonic anhydrase inhibitor, and nonsteroidal anti-inflammatory (NSAID) eye drops.
  • Data analysis focused on closure rates, time to closure, hole size, and the presence of vitreomacular traction (VMT).

Main Results:

  • Topical therapy resulted in FTMH closure in 18 out of 49 eyes (36.7%).
  • Smaller hole size was significantly correlated with increased odds of closure (P=0.001).
  • The presence of VMT was inversely related to successful closure (OR 6.1, P=0.029).

Conclusions:

  • Topical therapy offers a viable non-surgical option for FTMH closure, achieving a 36.7% success rate.
  • Efficacy is higher in smaller holes and those without VMT.
  • Macular hole narrowing and reduction in central foveal thickness predict successful response to topical therapy.