Purpose:
To describe 6 patients (6 eyes) who developed an eccentric macular hole after surgery for idiopathic epimacular proliferation.
Methods:
Retrospective review of 631 consecutive patients who underwent vitrectomy with peeling of the epimacular proliferation and in most cases the internal limiting membrane (ILM) from May 2001 to May 2005. Six patients were found to have developed an eccentric macular hole postoperatively.
Results:
Eccentric macular holes developed 9 days to 8 months (mean, 3.1 months) after epimacular proliferation peeling. The ILM was peeled in addition to the epimacular proliferation in 5 of the 6 cases. 4 of the 6 eccentric macular holes were located temporal to the fovea; one was located superior to the fovea; and one was located nasal to the fovea. Final visual acuities after a mean follow–up period of 17.3 months were 20/20 in 2 eyes, 20/25 in 1 eye, 20/40 in 2 eyes, and 5/200 in 1 eye. The eye with the eccentric macular hole nasal to the fovea had the poorest final visual acuity of 5/200.
Conclusions:
Eccentric macular holes occurring after vitrectomy surgery to remove epimacular proliferation is an uncommon postoperative finding. To our knowledge this is the largest case series of such patients reported. Various explanations have been suggested to explain the etiology of these holes, but there remains no consensus.
Keywords: macular holes • retina • macula/fovea