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Daniel Steven Churgin, Carlos Alonso Medina Mendez, Angelica Ortiz, William E Smiddy, Harry W Flynn; Macular Hole After Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1070.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical features, risk factors and treatment outcomes of patients with macular hole after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RD) at a university based referral center.
Retrospective consecutive case series (07/2009 to 07/2015). Patients with diabetic tractional retinal detachments and traumatic retinal detachments were excluded.
In the current study of 15 patients, macular hole was not visible before, during or immediately after RD surgery. The average time from RD surgery to macular hole diagnosis was 119 days (range: 41 - 398 months). No vitreous staining agents were used during the original RD surgery. Nine patients (60%) had a history of macula off RD, 9 (60%) had a history of recurrent RD, and 5/15 (33%) had a history of high myopia. Macular hole surgery was performed on all eyes. No patient had more than one macular hole surgery. Macular hole closure was accomplished in 11/15 (73%) eyes at last follow up (average 302 days). Of the 11 eyes with macular hole closure, best-corrected visual acuity of 20/200 or better was achieved in 8 eyes, but only 5 eyes achieved best-corrected visual acuity of 20/80 or better.
In eyes with macular hole formation after PPV for RD, risk factors include macula off RD, recurrent RD and high myopia. Macular hole closure was achieved in the majority of patients, but closure was associated with only modest visual improvement. Macular hole formation in these patients implies more than a purely tractional etiology.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
A series of photos showing a fundus photograph of the patient's RD (left), a fundus photograph of the the postoperative attached retina with macula hole (top right), and an optical coherence tomography after of the patient's RD repair showing a full-thickness macular hole (bottom right).
A series of photos showing resolution of the macular hole and maintenance of an attached retina on fundus photograph (top), and an optical coherence tomography after of the patient's macular hole repair showing closure of the macular hole and retinal atrophy (bottom).
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