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T.H. Huynh, M.W. Johnson; The Behavior of Surgically Repaired Idiopathic Macular Holes in the Setting of Subsequent Cystoid Macular Edema . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1467.
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To report clinical findings and outcomes in eyes with surgically repaired idiopathic macular holes that subsequently developed cystoid macular edema (CME).
Retrospective chart review of 6 eyes of 6 consecutive patients evaluated between January 1997 and October 2000 that had successful macular hole repair and subsequently developed CME. The diagnosis of CME was made on biomicroscopic examination, with fluorescein angiography and/or optical coherence tomography in select cases. Recorded information included patient demographics, apparent cause of CME, time course and duration of CME, treatment, and visual and anatomic outcomes, including macular hole reopening.
CME developed after cataract extraction in 5 eyes and after macular hole surgery alone in 1 pseudophakic eye. Average time from macular hole surgery to diagnosis of CME was 11.5 months (range, 2.5 to 23 months). Average duration of CME was 5.8 months (range, 1.5 to 17 months). Five of the 6 eyes (83%) demonstrated sustained closure of the macular hole throughout the follow–up period. In one eye, the macular hole reopened and underwent successful reoperation. All patients were treated with conventional topical anti–inflammatory therapy and showed complete resolution of macular edema.
CME developing in eyes with surgically repaired idiopathic macular holes responds well to conventional topical anti–inflammatory therapy. Surgically repaired macular holes do not appear to be at significant risk for reopening in the setting of subsequent CME. This suggests that the reparative mechanisms involved in macular hole closure confer sufficient strength to withstand the prolonged tensile forces associated with cystoid macular edema.
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