Spontaneous Closure of Full-Thickness Macular Holes

Nawrocka, Zofia; Nawrocki, Jerzy

doi:10.1159/000516768

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…Even in cases with spontaneous closure of the MH, because of prolonged defects of the choriocapillaris layer, complete visual recovery is uncommon. 18 These findings indicate that early surgical intervention in this situation is advisable.…”

Section: Discussionmentioning

confidence: 96%

Delayed macular hole secondary to Terson syndrome: a case report and literature review

Zhang,

Lei,

Huang

et al. 2024

J Int Med Res

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Terson syndrome refers to intraocular haemorrhage that occurs due to subarachnoid bleeding associated with an acute increase in intracranial pressure. No previous study has reported a delayed macular hole (MH) secondary to Terson syndrome. A 17-year-old boy visited our department and presented with vitreous bleeding and a history of subarachnoid haemorrhage. Sub-internal limiting membrane (ILM) haemorrhage with ILM detachment and intraretinal haemorrhage were detected during pars plana vitrectomy. Additionally, a delayed MH was detected 1 week after the surgery. There was no sign of MH closure during a 2-month follow-up. Subsequently, an MH massage was performed to close the MH. Our findings suggest that a delayed MH can occur secondary to Terson syndrome. Elevated hydrodynamic pressure and hydrostatic pressure, which are caused by sub-ILM and intraretinal haemorrhages of the fovea, contribute to the formation of an MH. Additionally, ILM peeling may cause damage to the macula and facilitate the formation of MHs. Although the MH may close by itself, early surgical intervention is recommended when there is no sign that the MH will close spontaneously because a prolonged MH can lead to retinal damage.

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Section: Discussionmentioning

confidence: 96%

Delayed macular hole secondary to Terson syndrome: a case report and literature review

Zhang,

Lei,

Huang

et al. 2024

J Int Med Res

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“…Moreover, we observed cases that developed a lamellar macular hole after spontaneous closure of FTMH, or that developed FTMH from PH or LMH, and some of them had favorable visual acuity after spontaneous closure. 27 However, eyes with coexisting FTMH and EP may tend to reopen once spontaneously closed (Figure 7). This suggests that the pathogenesis in these cases may be associated with horizontal traction.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of surgical success with the Inverted ILM Flap Technique

Nawrocka,

Nawrocki

2023

Retina

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Purpose: To present new morphological features correlating with functional and anatomical outcomes of the Inverted internal limiting membrane Flap Technique (iILMFT) in full-thickness macular hole (FTMH). Methods: A retrospective study of 51 successful and 22 failed FTMH surgeries. In all eyes, preoperative SD-OCT or SS-OCTs were reviewed. The presence of supra-RPE (retinal pigment epithelium) granular deposits, presence of an epiretinal membrane (ERM) or epiretinal proliferation (EP), visibility of posterior hyaloid, continuity of the interdigitation zone or external limiting membrane, presence of cystoid spaces, irregular surface of the margins of FTMH, visibility of the suprachoroidal space, diameters of FTMH were analyzed. Results: In multivariate analysis, the success of the first surgery depended solely on the absence of ERM (p<0.05). In univariate analysis, the success of the first surgery was correlated moreover with the absence of preoperative supra-RPE granular deposits (p=0.0010), the absence of an EP (p=0.0060), and the absence of an irregular border of the hole (p=0.010). Conclusions: In multivariate analysis, ERMs were a negative prognostic factor for macular hole closure when the iILMFT was used. Worse final visual acuity was observed in patients with primary anatomical failure, even if the hole was successfully closed during the second intervention.

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“…IFTMH closure rates were reported in various investigations to range from 2.4% to 17%. [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ] The cumulative closure rate for the prospective studies was 16% (12 of 73) [Table 1]. In a literature review of IFTMH,spontaneous closure rates werestratified by hole size: 22.2% for holes

250 µm; 13.3% for 250–400 µm and 0% for

400 µm.…”

Section: Methodsmentioning

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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Spontaneous Closure of Full-Thickness Macular Holes

Cited by 8 publications

References 16 publications

Delayed macular hole secondary to Terson syndrome: a case report and literature review

Delayed macular hole secondary to Terson syndrome: a case report and literature review

Predictive factors of surgical success with the Inverted ILM Flap Technique

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

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