Spontaneous evolution of stage I and II macular holes

To ascertain the natural outcome of stage I impending and stage II macular holes, 28 eyes (26 patients) were reviewed and followed up for an average of 23 months. Of the 21 stage I lesions, 10 (47.6%) progressed and the others regressed. In the stage II group (9 eyes), 5 lesions (55.5%) progressed, 2 (22.2%) regressed and 2 (22.2%) remained stable during a follow-up period of 7.75 months. Patients with stage II macular holes seem to be more likely to benefit from surgery than patients with stage I lesions. However, even in stage II macular holes, regression may be observed and the possible benefit from surgery must be weighed against the known complications and risk factors.