Nonsurgical Resolution of Full-Thickness Macular Holes Without Vitreomacular Traction

Richards, Paige; Kulkarni, Amol D.; Nork, T. Michael; Leys, Monique; Hinkle, David M.; Conlin, Karina; Chang, Stanley; Chang, Jonathan S.

doi:10.1097/icb.0000000000001249

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Forty-nine studies had complete data with a total of 181 eyes forming the basis of our analysis [Table 2]. [ 18 ][ 19 ][ 20 ][ 21 ][ 22 ][ 23 ][ 24 ][ 25 , 26 , 27 , 28 ][ 29 ][ 30 ][ 31 ][ 32 ][ 33 ][ 34 ][ 35 ][ 36 ][ 37 ][ 38 ][ 39 ][ 40 ][ 41 ][ 42 ][ 43 ][ 44 ][ 45 ][ 46 ][ 47 ][ 48 ][ 49 ][ 50 ][ 51 ][ 52 ][ 53 ][ 54 ][ 55 ][ 56 ] Mean vision improved significantly ( P

0.005) from 20/65 to 20/41 over a mean follow-up of two years. The median diameter of IFTMH was 166 with 81.1% being categorized as small holes.…”

Section: Resultsmentioning

confidence: 99%

Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review

M Mansour,

Parodi,

H Uwaydat

et al. 2023

JOVR

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Our purpose is to review the closure time and optical coherence tomography (OCT) biomarkers that result in the non-surgical repair of idiopathic full-thickness macular holes (IFTMH). Our methodology consisted of a comprehensive literature review of the nonsurgical resolution of IFTMH followed by the calculation of the estimated closure time using the structural equation model. Forty-nine studies were found eligible yielding 181 eyes with IFTMH: 81.1% being small holes (<250 μm) with a median diameter of 166 μm. Final vision (mean 20/41) was related to initial vision (mean 20/65) and mean age (67 years). The hole diameter was correlated with initial vision and closure time (mean 3.9 months). Closure time was related to hole diameter and initial vision in the following algorithm: Closure time (month)= −0.057 + 0.008 diameter (μm) + 0.021 age (year) + 2.153 initial vision (logMAR). Biomarkers by OCT for self-closure included in decreasing frequency: pointed edge, de-turgescence of cystic macular edema (CME) with reversal of bascule bridge, and vitreomacular traction (VMT) release. The crucial function of Muller cell bridging in sealing the hole attests to its exceptional capacity for regeneration. After the hole has begun to close; however in less than 5%, a delayed restoration of the ellipsoid layer or a persistent outer foveal defect may prevent visual recovery and reopening of the hole is possible. In conclusion, eyes with small-size IFTMH and good baseline vision can have the additional option of close OCT monitoring for biomarkers of self-sealing biomarkers. When rehabilitative activity seems to be lacking, surgery is therefore mandatory.

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0.005) from 20/65 to 20/41 over a mean follow-up of two years. The median diameter of IFTMH was 166 with 81.1% being categorized as small holes.…”

Section: Resultsmentioning

confidence: 99%

Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review

M Mansour,

Parodi,

H Uwaydat

et al. 2023

JOVR

View full text Add to dashboard Cite

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Topical dorzolamide for macular holes: A randomised, double‐blind, placebo‐controlled trial

Lee,

Bahrami,

Baranage

et al. 2024

Clinical Exper Ophthalmology

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BackgroundTo assess topical dorzolamide as medical therapy for idiopathic full‐thickness macular holes (FTMHs).MethodsRandomised, double‐blinded, placebo‐controlled, single‐centre clinical trial involving 32 patients with idiopathic small FTMHs (<400 ). Participants in both arms used topical dorzolamide 2% or saline thrice daily for 8 weeks with monthly OCT. Those with persisting FTMH underwent vitrectomy with ILM peel and gas tamponade. The primary outcome was the rate of FTMH closure at the end of treatment.ResultsBetween 6 March 2020 and 16 June 2023, 32 eligible patients were enrolled: 16 participants in each arm. All participants in both groups were included in the final analysis. At the final visit, 3 of 16 (18.8%) patients in both the topical dorzolamide and placebo group demonstrated closure. There was no statistically significant difference in the proportion of FTMH closure between the control and treatment group (p = 1.00), nor statistically significant difference in the mean change in best corrected visual acuity (BCVA; p = 0.909). There was no difference in the change in FTMH diameter between groups (p = 0.225). No serious adverse events were reported in either group.ConclusionTopical dorzolamide was safe but not superior to placebo in the functional and anatomical outcomes of FTMH.

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Nonsurgical Resolution of Full-Thickness Macular Holes Without Vitreomacular Traction

Cited by 2 publications

References 10 publications

Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review

Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review

Topical dorzolamide for macular holes: A randomised, double‐blind, placebo‐controlled trial

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