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Related Experiment Video

Updated: Apr 14, 2026

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Axial Length as a Risk Factor for Idiopathic Macular Hole: A Five-Year Prospective Study.

Yongwun Cho1, Hayoung Byun2,3, Woong-Sun Yoo1,3

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|April 13, 2026
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Short axial length is a significant risk factor for developing new idiopathic macular holes in the fellow eye. This finding aids in identifying high-risk patients for targeted follow-up strategies.

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axial lengthfellow eyemacular holeprospective study

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Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Ocular Biometry

Background:

  • Idiopathic macular holes (IMH) can affect one or both eyes.
  • Understanding risk factors for fellow eye involvement is crucial for patient management.

Purpose of the Study:

  • To investigate the association between axial length and the incidence of new IMH in the fellow eye of patients with unilateral IMH.
  • To determine if short axial length is a predictive factor for fellow eye IMH development.

Main Methods:

  • A 5-year prospective follow-up study involving 100 patients with unilateral IMH and age/sex-matched controls.
  • Prospective observation of macular hole incidence in the fellow eye.
  • Comparison of mean axial length between fellow eyes that developed IMH and those that did not.

Main Results:

  • 11% of fellow eyes in the unilateral IMH group developed a new macular hole over 5 years; none occurred in the control group.
  • Fellow eyes that developed new IMH had a significantly shorter mean axial length (21.42 mm) compared to those that did not (22.98 mm).
  • The difference in axial length was statistically significant (p < 0.001).

Conclusions:

  • Short axial length is a significant risk factor for the development of new idiopathic macular holes in the fellow eye.
  • Axial length measurement is a practical and accessible parameter for identifying patients at higher risk for fellow eye IMH.
  • Findings support incorporating axial length into clinical assessments for guiding follow-up strategies in unilateral IMH patients.