[Changes in the vitreomacular border of the partner eye in macular foramina]

The incidence of a macular hole in the fellow eye of patients with macular hole stage I-IV according to Gass is observed in 3-14% of cases. The development of a macular hole over a period of 19-54 months is reported to occur in 1-22% of patients. Our clinical impression made us suspect a much higher number of changes at the vitreomacular interphase in the generally asymptomatic "second eye" already at first presentation in the hospital. We retrospectively examined 88 patients who presented with a macular hole between January and October 1994. We investigated the frequency of a macular hole or macular pucker in the fellow eye, taking into consideration that many common pathogenetic factors were described for these changes of the vitreoretinal interphase. We further examined the difference in number and appearance of macular pathology in the fellow eye between patients who had macular hole surgery in their "first eye" and patients whose "first eye" was observed. The group of patients whose "first eye" was operated on showed a macular hole stage I or stage II in 8% each in the "second eye", and a macular hole stage III/IV in 6% of cases. Patients whose "first eye" was observed were found to have only early macular holes in 18% of fellow eyes. Altogether, the fellow eye of patients with macular hole exhibited also a macular hole in 21% of patients and a macular pucker in 7% of patients. The incidence of pathological changes at the vitreomacular interface in 28% of the fellow eyes of patients with macular hole is higher than ever reported in the literature. The presence of early macular holes as well as early macular puckers supports clinically the thesis of common factors in the pathogenesis of these two disorders. As we only reviewed the incidence of pathological charges in this study, a much higher number of developing macular holes and macular puckers has to be expected in the fellow eye of patients with macular hole over a certain time period.