July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Medical Treatment of Macular Holes
Author Affiliations & Notes
  • Jared Todd Sokol
    Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States
  • Sidney Schechet
    Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States
  • Jerome Vincent Giovinazzo
    Ophthalmology, New York Eye and Ear of Mount Sinai, New York, New York, United States
  • Shaun Ittiara
    Retinal Vitreal Consultants, Chicago, Illinois, United States
  • Asim Farooq
    Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States
  • Veeral Shath
    University Retina, Oak Forest, Illinois, United States
    llinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, United States
  • Rahul Komati
    Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States
  • Ronald Gentile
    Ophthalmology, New York Eye and Ear of Mount Sinai, New York, New York, United States
  • Dimitra Skondra MD,PhD
    Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Jared Sokol, None; Sidney Schechet, None; Jerome Giovinazzo, None; Shaun Ittiara, None; Asim Farooq, None; Veeral Shath, Alimera (C), Genentech (C), NotalVision (C); Rahul Komati, None; Ronald Gentile, Acucela (F), Alcon Laboratories, Inc. (C), Genentech (F), Notal Vision Inc. (F), Quark Pharmaceuticals (F), Regeneron Pharmaceuticals, Inc. (F); Dimitra Skondra MD,PhD, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5042. doi:
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      Jared Todd Sokol, Sidney Schechet, Jerome Vincent Giovinazzo, Shaun Ittiara, Asim Farooq, Veeral Shath, Rahul Komati, Ronald Gentile, Dimitra Skondra MD,PhD; Medical Treatment of Macular Holes. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5042.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Macular holes (MHs) are a common retinal disorder which usually requires surgical treatment with pars plana vitrectomy. Here we present a case series of MHs that had successful closure with topical medical treatment.

Methods : We conducted a retrospective review of the medical records, including optical coherence tomography (OCT) studies, of 11 patients with full-thickness macular holes that responded favorably to medical treatment. Treatment included steroid, non-steroidal anti-inflammatory (NSAID), and carbonic anhydrase inhibitor (CAI) drops.

Results : 8 men and 3 women with an average age of 67.5 years were included in the study. 7 out of 11 eyes had prior vitrectomy (4 for retinal detachment and 3 for previous MH) and non-vitrectomized eyes had vitreous separation from the macula. MHs were diagnosed clinically and confirmed by OCT. The initial OCT study in all cases revealed a full-thickness MH (mean size +/- SD = 184um +/- 80um) with surrounding cystoid hydration. After starting topical medical therapy (steroid + NSAID + CAI), follow-up OCT studies revealed decreases in cystic changes within 2 to 4 weeks and MH closure with visual acuity improvement in 4-8 weeks. Average best-corrected visual acuity improved from 20/82 at initial presentation to 20/40 after MH closure.

Conclusions : Small full-thickness MHs, especially in previously vitrectomized eyes or those with macular vitreous separation, may benefit from topical medical therapy with steroid, NSAID, and CAI drops. Prospective controlled studies are warranted to further elucidate the use of medical therapy in the treatment of MHs and to better understand if medical treatment could be a conservative alternate to surgery.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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