Macular holes: Pathogenesis, natural history and surgical outcomes

Abstract

Idiopathic full-thickness macular holes (FTMH) are a common cause of usually uniocular reduced visual acuity. The accepted pathogenesis has macular hole formation proceeding in stages from an impending hole to a FTMH, with visual acuity deteriorating to less than 6/60 in 85% of cases. Recent surgical advances in the treatment of FTMH, with excellent anatomic and visual results, have changed the surgical indications for both impending and established full-thickness macular holes.

Prevalence of idiopathic macular hole in adult rural and urban south Indian population

“…5 The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older. 1 Our age-and gender-adjusted prevalence rate of 0.28% agrees with results from hospital-based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study. 3,4,12,13 These studies also noted that unilateral holes were more common than bilateral holes as seen in our study.…”

“…Similarly, the Aravind Comprehensive Eye Study from the state of Tamil Nadu in Southern India conducted a similar survey albeit on a subset of patients with vitreo‐retinal disorders, and found the prevalence of macular holes approximately 0.8% 5 . The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older 1 . Our age‐ and gender‐adjusted prevalence rate of 0.28% agrees with results from hospital‐based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study 3,4,12,13 .…”

Prevalence of idiopathic macular hole in adult rural and urban south Indian population

“…5 The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older. 1 Our age-and gender-adjusted prevalence rate of 0.28% agrees with results from hospital-based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study. 3,4,12,13 These studies also noted that unilateral holes were more common than bilateral holes as seen in our study.…”

“…Similarly, the Aravind Comprehensive Eye Study from the state of Tamil Nadu in Southern India conducted a similar survey albeit on a subset of patients with vitreo‐retinal disorders, and found the prevalence of macular holes approximately 0.8% 5 . The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older 1 . Our age‐ and gender‐adjusted prevalence rate of 0.28% agrees with results from hospital‐based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study 3,4,12,13 .…”

Macular Hole After Vitrectomy for Primary Rhegmatogenous Retinal Detachment

“…8,17,20 The prevalence of idiopathic MHs among an approximately age-matched group in the general population was found to be approximately 0.3%. [21][22][23][24] Thus, the occurrence of MHs in our case series was more than three times greater compared with the general population. It is possible that eyes after PPV for RRD are in greater risk for the development of MH; however, the small size of our series does not allow a definite conclusion on this issue.…”

Patient Expectation and Satisfaction After Macular Hole Surgery

“…Macular holes often have a debilitating effect on vision. 24,25 We believe that because of this, most patients with macular holes would consider surgery given that this offers the only likely chance for any improvement in vision. This may be true even for patients dissatisfied with the outcome and would explain why these six patients said that they would undergo surgery again.…”

Prevalence of idiopathic macular hole in adult rural and urban south Indian population

“…5 The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older. 1 Our age-and gender-adjusted prevalence rate of 0.28% agrees with results from hospital-based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study. 3,4,12,13 These studies also noted that unilateral holes were more common than bilateral holes as seen in our study.…”

“…Similarly, the Aravind Comprehensive Eye Study from the state of Tamil Nadu in Southern India conducted a similar survey albeit on a subset of patients with vitreo‐retinal disorders, and found the prevalence of macular holes approximately 0.8% 5 . The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older 1 . Our age‐ and gender‐adjusted prevalence rate of 0.28% agrees with results from hospital‐based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study 3,4,12,13 .…”

Macular Hole After Vitrectomy for Primary Rhegmatogenous Retinal Detachment

“…8,17,20 The prevalence of idiopathic MHs among an approximately age-matched group in the general population was found to be approximately 0.3%. [21][22][23][24] Thus, the occurrence of MHs in our case series was more than three times greater compared with the general population. It is possible that eyes after PPV for RRD are in greater risk for the development of MH; however, the small size of our series does not allow a definite conclusion on this issue.…”

Patient Expectation and Satisfaction After Macular Hole Surgery

“…Macular holes often have a debilitating effect on vision. 24,25 We believe that because of this, most patients with macular holes would consider surgery given that this offers the only likely chance for any improvement in vision. This may be true even for patients dissatisfied with the outcome and would explain why these six patients said that they would undergo surgery again.…”

Prevalence of idiopathic macular hole in adult rural and urban south Indian population

“…5 The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older. 1 Our age-and gender-adjusted prevalence rate of 0.28% agrees with results from hospital-based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study. 3,4,12,13 These studies also noted that unilateral holes were more common than bilateral holes as seen in our study.…”

“…Similarly, the Aravind Comprehensive Eye Study from the state of Tamil Nadu in Southern India conducted a similar survey albeit on a subset of patients with vitreo‐retinal disorders, and found the prevalence of macular holes approximately 0.8% 5 . The prevalence of macular holes in the general population of the United States has been estimated to be approximately 3.3 per 1000 people aged 55 years or older 1 . Our age‐ and gender‐adjusted prevalence rate of 0.28% agrees with results from hospital‐based studies which reported a prevalence of approximately 0.3% for the populations of the Beaver Dam Eye Study, Blue Mountains Eye Study and Baltimore Eye Study 3,4,12,13 .…”

Macular Hole After Vitrectomy for Primary Rhegmatogenous Retinal Detachment

“…8,17,20 The prevalence of idiopathic MHs among an approximately age-matched group in the general population was found to be approximately 0.3%. [21][22][23][24] Thus, the occurrence of MHs in our case series was more than three times greater compared with the general population. It is possible that eyes after PPV for RRD are in greater risk for the development of MH; however, the small size of our series does not allow a definite conclusion on this issue.…”

Patient Expectation and Satisfaction After Macular Hole Surgery

“…Macular holes often have a debilitating effect on vision. 24,25 We believe that because of this, most patients with macular holes would consider surgery given that this offers the only likely chance for any improvement in vision. This may be true even for patients dissatisfied with the outcome and would explain why these six patients said that they would undergo surgery again.…”