Purchase this article with an account.
R. Hamano, Y. Shimoda, S. Kishi; Tomographic Features of Spontaneous Closure of Full–thickness Macular Holes . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5435.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose:To describe the process of spontaneous closure in full–thickness macular holes. Methods: We followed up 5 eyes of 5 patients (5 women) with full–thickness macular holes which developed spontaneous closure between July 1998 and August 2004. The patients’ age ranged from 25 to 65 (mean, 55).Follow–up periods ranged from 3 to 56 months (average, 18). The cases included one eye with stage 2, 2 eyes with stage 3 and 2 eyes with stage 4. We observed the process of macular hole closure by repeated optical coherence tomography (OCT). Results: All five eyes had micro hole whose diameter ranged from 94 to 158 um (average, 120). One eye had stage 1 macular hole with foveal detachment at initial visit. It developed stage 2 hole 10 days later. The roof of stage 2 hole was sealed but intraretinal splitting and foveal detachment was present at 6 weeks. Vitreoretinal attachment with perifoveal vitreous detachment was seen. At 5 months, the fovea restored normal configuration along with vitreofoveal separation. In 2 eyes with stage 3 and 2 eyes with stage 4 hole, centripetal protrusion of inner retina at the outer margin of macular holes took place, then the protruded inner retina bridged the anterior surface of the hole. This feature was identical to foveal retinal detachment at stage 1. Foveal detachment gradually disappeared and these eyes restored normal foveal configuration. Visual acuity was improved in all 5 eyes. The periods for hole closure were 2.5 to 9 months (average, 6.3). Conclusions: Small macular hole can close spontaneously after vitreofoveal separation. Sealing of hole initiated with roof formation by centripetal protrusion of inner retina. Then foveal detachment is filled with retinal tissue or reattached.
This PDF is available to Subscribers Only