Clinical characteristics of full thickness macular holes that closed without surgery

Sami H. Uwaydat, Ahmad Mansour, Francisco J. Ascaso, Maurizio Battaglia Parodi, Robert Foster, William E. Smiddy, Stephen G. Schwartz, Abdulrazzak Charbaji, Silvana Belotto, Ignasi Jürgens, Javier Mateo, Abdallah A. Ellabban, Lihteh Wu, Marta Figueroa, Nuria Olivier Pascual, Luiz H. Lima, Wael A. Alsakran, Sibel Caliskan Kadayifcilar, Suthasinee Sinawat, Alexandre AssiHana A. Mansour, Antonio Marcello Casella, Amparo Navea, Elena Rodríguez Neila, A. Osman Saatci, Vishal Govindahari, Olivia Esteban Floria, Komal Agarwal, Ismael Bakkali El Bakkali, Angel Salinas Alaman, Sofia Fernandez Larripa, Amanda Rey, Patricia Pera, Lluís Bruix, Lorenzo Lopez-Guajardo, Eduardo Pérez-Salvador, Francisco Javier Lara Medina, Frank N. Hrisomalos, Jay Chhablani, J. Fernando Arevalo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To ascertain the anatomic factors that help achieve non-surgical sealing in full thickness macular hole (FTMH). Methods: Retrospective collaborative study of FTMH that closed without surgical intervention. Results: A total of 78 patients (mean age 57.9 years) included 18 patients with blunt ocular trauma, 18 patients that received topical or intravitreal therapies and 42 patients with idiopathic FTMH. Mean±SD of the initial corrected visual acuity (VA) in logMAR improved from 0.65±0.54 to 0.34±0.45 (p<0.001) at a mean follow-up of 33.8±37.1 months. FTMH reopened in seven eyes (9.0%) after a mean of 8.6 months. Vitreomacular traction was noted in 12 eyes (15.8%), perifoveal posterior vitreous detachment in 42 (53.8%), foveal epiretinal membrane in 10 (12.8%), cystoid macular oedema (CME) in 49 (62.8%) and subretinal fluid (SRF) in 20 (25.6%). By multivariate analysis, initial VA correlated to the height (p<0.001) and narrowest diameter of the hole (p<0.001) while final VA correlated to the basal diameter (p<0.001). Time for closure of FTMH (median 2.8 months) correlated to the narrowest diameter (p<0.001) and the presence of SRF (p=0.001). Mean time for closure (in months) was 1.6 for eyes with trauma, 4.3 for eyes without trauma but with therapy for CME, 4.4 for eyes without trauma and without therapy in less than 200 μm in size and 24.7 for more than 200 μm. Conclusion: Our data suggest an observation period in new onset FTMH for non-surgical closure, in the setting of trauma, treatment of CME and size <200 μm.

Original languageEnglish (US)
Article number319001
JournalBritish Journal of Ophthalmology
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • Macula
  • Retina
  • Trauma
  • Treatment Medical

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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