Size and vitreomacular attachment of Full Thickness Macular Hole

Abstract

Purpose: To study the correlation between the vitreomacular attachment and the size of primary full-thickness macular holes.

Methods: Retrospective observational case series. The records of 100 consecutive patients operated for primary full thickness macular hole (FTMH) between 2012 and 2013 were reviewed. Collected data included the best corrected visual acuity (BCVA), fundus examination and preoperative spectral domain-optical coherence tomography (SD-OCT). Patients were sorted according to the International Vitreomacular Traction Study Group classification, by the presence of a vitreomacular traction (VMT), and according to their size, as small (less than 250µm), medium (250µm-400µm) and large (more than 400µm), measured on SD-OCT horizontal scans.

Results: Baseline characteristics were: men/women ratio of 29/71, mean age of 71,1 ± 7 years (52-89). A vitreomacular traction was present in 22% of eyes. The mean preoperative diameter of holes was not significantly different according to the presence of a VMT: 339 ± 134µm in eyes with VMT and 423 ± 191µm in eyes without VMT (p=0,057).The distribution of FTMH according to size and presence of a VMT was not significantly different (p=0,69): respectively 19%, 32% and 49% of small, medium and large FTMH in the group with VMT and 27%, 32% and 41% in the group without VMT. In our series, 6% of patients presented with small FTMH and VMT and 13% of patient with FTMH less than 400µm and VMT.

Conclusions: In our series of 100 FTMH, there was no significant relation between the size of hole and the presence of a vitreomacular traction, despite the supposed role of the vitreous traction in FTMH pathogenesis. Only 13% of FTMH had a VMT and a diameter less than 400µm, for which vitreolysis has been proposed as possible treatment.