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Daniel Su, Anthony Obeid, Jason Hsu; Topical Aqueous Suppression and Spontaneous Closure of Idiopathic Full-Thickness Macular Holes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):866.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effect of topical aqueous suppression on idiopathic full-thickness macular holes
We retrospectively included eyes with idiopathic full-thickness macular holes that were started on combination topical timolol/dorzolamide and monitored for potential spontaneous closure. Clinical data including duration of treatment with topical aqueous suppression, closure of macular hole, duration of follow up, lens status, presence of posterior vitreous detachment, and visual acuity were recorded. Optical coherence tomography (OCT) images were reviewed for the size of macular holes, the presence of cystoid changes, the number and size of cystoid fluid spaces, and choroidal thickness.
A case series of four eyes were included. Two out of four eyes had spontaneous closure after 4 weeks of topical timolol/dorzolamide with associated improvement in vision (Figure. 1). One of these eyes had prior vitrectomy for retinal detachment. Both eyes remained stable without surgical intervention 6 months after macular hole closure. The other two eyes had persistent macular holes after 4 weeks of topical therapy but both achieved closure with vitrectomy. Visual acuity improved in all but one eye after anatomical closure. Clinical and OCT features of all 4 eyes are included in Table.
Cystoid dehydration has been proposed as a potential mechanism for spontaneous closure of idiopathic macular hoes, and may be aided by topical aqueous suppression. In this limited case series, no correlation between cystoid dehydration and spontaneous closures were observed. Further investigation with a larger study is required.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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