Macular Hole

Soumyadeep Majumdar, Koushik Tripathy, Soumyadeep Majumdar, Koushik Tripathy

Excerpt

Macular hole (MH) is a vitreoretinal interface disease characterized by a partial or full-thickness neurosensory retinal defect in the center of the macula. Macular hole, per se, has not been studied a lot up to the early nineties. The diagnosis and treatment plan has been dramatically changed in the last two decades. A new classification system based on morphology and vitreoretinal interface pathology has convincingly revealed the pathways related to the formation of a macular hole. The diagnosis and follow-up after treatment, clinically as well as by optical coherence tomography (OCT), has become definitive nowadays. Due to central foveal involvement, metamorphopsia and visual deprivation are the common presenting symptoms that may be reversible after successful anatomical closure following surgery.

Conflict of interest statement

Disclosure: Soumyadeep Majumdar declares no relevant financial relationships with ineligible companies.

Disclosure: Koushik Tripathy declares no relevant financial relationships with ineligible companies.

Copyright © 2024, StatPearls Publishing LLC.

References

    1. Gattoussi S, Buitendijk GHS, Peto T, Leung I, Schmitz-Valckenberg S, Oishi A, Wolf S, Deák G, Delcourt C, Klaver CCW, Korobelnik JF, European Eye Epidemiology (E3) consortium The European Eye Epidemiology spectral-domain optical coherence tomography classification of macular diseases for epidemiological studies. Acta Ophthalmol. 2019 Jun;97(4):364-371.
    1. Azzolini C. Macular Hole: From Diagnosis to Therapy. J Ophthalmol. 2020;2020:1473763.
    1. Stein GE, Jung JJ, Bodine S, Trokel SL, Chang S. Vitrectomy for macular hole following Nd:YAG laser injury. Taiwan J Ophthalmol. 2016 Oct-Dec;6(4):195-198.
    1. Pillai GS, Varkey R, Unnikrishnan UG, Radhakrishnan N. Incidence and risk factors for intraocular pressure rise after transconjunctival vitrectomy. Indian J Ophthalmol. 2020 May;68(5):812-817.
    1. Chino M, Yoshikawa Y, Kanno J, Nagashima T, Sakaki Y, Katsumoto T, Shibuya M, Shoji T, Makita J, Shinoda K. Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report. BMC Ophthalmol. 2020 Mar 17;20(1):108.
    1. Peart S, Ramsay A, Khan QA, Leong T, Gordon-Bennett P. Large, Spontaneous Macular Hole with Posterior Pole Detachment in a Patient with Best Vitelliform Macular Dystrophy. Case Rep Ophthalmol. 2019 May-Aug;10(2):221-226.
    1. Tsuiki E, Kusano M, Kitaoka T. Complication associated with intravitreal injection of tissue plasminogen activator for treatment of submacular hemorrhage due to rupture of retinal arterial macroaneurysm. Am J Ophthalmol Case Rep. 2019 Dec;16:100556.
    1. Levison AL, Schachat AP. Macular hole from a central retinal artery occlusion. JAMA Ophthalmol. 2014 Dec;132(12):1493.
    1. Fragiotta S, Rossi T, Carnevale C, Cutini A, Tricarico S, Casillo L, Scuderi G, Vingolo EM. Vitreo-macular interface disorders in retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol. 2019 Oct;257(10):2137-2146.
    1. Raimundo M, Fonseca C, Silva R, Figueira J. Bilateral giant macular holes: A rare manifestation of Alport syndrome. Eur J Ophthalmol. 2019 Jan;29(1):NP13-NP16.
    1. Xie ZG, Yu SQ, Chen X, Zhu J, Chen F. Macular hole secondary to Valsalva retinopathy after doing push-up exercise. BMC Ophthalmol. 2014 Aug 12;14:98.
    1. Rizzo S, Mucciolo DP, Bacherini D, Murro V, Vannozzi L, Virgili G, Bani D, Sodi A. Macular hole in Stargardt disease: Clinical and ultra-structural observation. Ophthalmic Genet. 2017 Sep-Oct;38(5):486-489.
    1. Li Y, Li Z, Xu C, Liu Y, Kang X, Wu J. Autologous neurosensory retinal transplantation for recurrent macular hole retinal detachment in highly myopic eyes. Acta Ophthalmol. 2020 Dec;98(8):e983-e990.
    1. Liao DY, Liu JH, Zheng YP, Shiu HW, Wang JM, Chao HM. OCT proves that vitreomacular adhesion is significantly more likely to develop vision-threatening retinal complications than vitreomacular separation. BMC Ophthalmol. 2020 Apr 22;20(1):163.
    1. Gao M, Liu K, Lin Q, Liu H. Management Modalities for Traumatic Macular Hole: A Systematic Review and Single-Arm Meta-Analysis. Curr Eye Res. 2017 Feb;42(2):287-296.
    1. Chen HJ, Jin Y, Shen LJ, Wang Y, Li ZY, Fang XY, Wang ZL, Huang XD, Wang ZJ, Ma ZZ. Traumatic macular hole study: a multicenter comparative study between immediate vitrectomy and six-month observation for spontaneous closure. Ann Transl Med. 2019 Dec;7(23):726.
    1. Lewis ML, Cohen SM, Smiddy WE, Gass JD. Bilaterality of idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol. 1996 Apr;234(4):241-5.
    1. Trempe CL, Weiter JJ, Furukawa H. Fellow eyes in cases of macular hole. Biomicroscopic study of the vitreous. Arch Ophthalmol. 1986 Jan;104(1):93-5.
    1. la Cour M, Friis J. Macular holes: classification, epidemiology, natural history and treatment. Acta Ophthalmol Scand. 2002 Dec;80(6):579-87.
    1. McCannel CA, Ensminger JL, Diehl NN, Hodge DN. Population-based incidence of macular holes. Ophthalmology. 2009 Jul;116(7):1366-9.
    1. Ali FS, Stein JD, Blachley TS, Ackley S, Stewart JM. Incidence of and Risk Factors for Developing Idiopathic Macular Hole Among a Diverse Group of Patients Throughout the United States. JAMA Ophthalmol. 2017 Apr 01;135(4):299-305.
    1. Risk factors for idiopathic macular holes. The Eye Disease Case-Control Study Group. Am J Ophthalmol. 1994 Dec 15;118(6):754-61.
    1. Morgan CM, Schatz H. Involutional macular thinning. A pre-macular hole condition. Ophthalmology. 1986 Feb;93(2):153-61.
    1. Ozawa Y, Shinoda H, Nagai N, Tsubota K. Dynamic changes in neural retinal images during the development of a lamellar macular hole: A case report. Medicine (Baltimore) 2019 Dec;98(49):e18297.
    1. Green WR. The macular hole: histopathologic studies. Arch Ophthalmol. 2006 Mar;124(3):317-21.
    1. Liu J, Peng J, Zhang Q, Ma M, Zhang H, Zhao P. Etiologies, Characteristics, and Management of Pediatric Macular Hole. Am J Ophthalmol. 2020 Feb;210:174-183.
    1. Xin W, Cai X, Xiao Y, Ji L, Gu Y, Lv W, Jiang J. Surgical treatment for type II macular hole retinal detachment in pathologic myopia. Medicine (Baltimore) 2020 Apr;99(17):e19531.
    1. Ezra E, Munro PM, Charteris DG, Aylward WG, Luthert PJ, Gregor ZJ. Macular hole opercula. Ultrastructural features and clinicopathological correlation. Arch Ophthalmol. 1997 Nov;115(11):1381-7.
    1. Sebag J. [The vitreoretinal interface and its role in the pathogenesis of vitreomaculopathies]. Ophthalmologe. 2015 Jan;112(1):10-9.
    1. Quinn NB, Steel DH, Chakravarthy U, Peto T, Hamill B, Muldrew A, Graham K, Elliott D, Hennessy R, Cruise S, McGuinness B, Young IS, Kee F, Hogg RE. Assessment of the Vitreomacular Interface Using High-Resolution OCT in a Population-Based Cohort Study of Older Adults. Ophthalmol Retina. 2020 Aug;4(8):801-813.
    1. Folk JC, Boldt HC, Keenum DG. Foveal cysts: a premacular hole condition associated with vitreous traction. Arch Ophthalmol. 1998 Sep;116(9):1177-83.
    1. Cicinelli MV, Marchese A, Bandello F, Coppola M. Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography. J Ophthalmol. 2019;2019:3821479.
    1. Saxena S, Holekamp NM, Kumar A. Diagnosis and management of idiopathic macular holes. Indian J Ophthalmol. 1998 Dec;46(4):185-93.
    1. Venkatesh R, Mohan A, Sinha S, Aseem A, Yadav NK. Newer indices for predicting macular hole closure in idiopathic macular holes: A retrospective, comparative study. Indian J Ophthalmol. 2019 Nov;67(11):1857-1862.
    1. Sjaarda RN, Frank DA, Glaser BM, Thompson JT, Murphy RP. Resolution of an absolute scotoma and improvement of relative scotomata after successful macular hole surgery. Am J Ophthalmol. 1993 Aug 15;116(2):129-39.
    1. Tripathy K, Salini B. StatPearls [Internet] StatPearls Publishing; Treasure Island (FL): 2023. Aug 25, Amsler Grid.
    1. Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991 May;109(5):654-9.
    1. Liang X, Liu W. Characteristics and Risk Factors for Spontaneous Closure of Idiopathic Full-Thickness Macular Hole. J Ophthalmol. 2019;2019:4793764.
    1. Khan MA, Haller JA. Ocriplasmin for Treatment of Vitreomacular Traction: An Update. Ophthalmol Ther. 2016 Dec;5(2):147-159.
    1. Eckardt C, Eckardt U, Groos S, Luciano L, Reale E. [Removal of the internal limiting membrane in macular holes. Clinical and morphological findings]. Ophthalmologe. 1997 Aug;94(8):545-51.
    1. Muqit MMK, Hamilton R, Ho J, Tucker S, Buck H. Intravitreal ocriplasmin for the treatment of vitreomacular traction and macular hole- A study of efficacy and safety based on NICE guidance. PLoS One. 2018;13(5):e0197072.
    1. Juncal VR, Chow DR, Vilà N, Kapusta MA, Williams RG, Kherani A, Berger AR. Ocriplasmin versus vitrectomy for the treatment of macular holes. Can J Ophthalmol. 2018 Oct;53(5):441-446.
    1. Prospero Ponce CM, Stevenson W, Gelman R, Agarwal DR, Christoforidis JB. Ocriplasmin: who is the best candidate? Clin Ophthalmol. 2016;10:485-95.
    1. Rodrigues EB, Meyer CH. Meta-analysis of chromovitrectomy with indocyanine green in macular hole surgery. Ophthalmologica. 2008;222(2):123-9.
    1. Stalmans P, Van Aken EH, Veckeneer M, Feron EJ, Stalmans I. Toxic effect of indocyanine green on retinal pigment epithelium related to osmotic effects of the solvent. Am J Ophthalmol. 2002 Aug;134(2):282-5.
    1. Shukla D, Kalliath J, Neelakantan N, Naresh KB, Ramasamy K. A comparison of brilliant blue G, trypan blue, and indocyanine green dyes to assist internal limiting membrane peeling during macular hole surgery. Retina. 2011 Nov;31(10):2021-5.
    1. Michalewska Z, Michalewski J, Adelman RA, Nawrocki J. Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology. 2010 Oct;117(10):2018-25.
    1. Michalewska Z, Nawrocki J. Vitrectomy with the inverted internal limiting membrane flap technique in eyes with full-thickness macular hole and dry age-related macular degeneration. Eur J Ophthalmol. 2021 May;31(3):1320-1325.
    1. Ye T, Yu JG, Liao L, Liu L, Xia T, Yang LL. Macular hole surgery recovery with and without face-down posturing: a meta-analysis of randomized controlled trials. BMC Ophthalmol. 2019 Dec 21;19(1):265.
    1. Berger JW, Brucker AJ. The magnitude of the bubble buoyant pressure: implications for macular hole surgery. Retina. 1998;18(1):84-6; author reply 86-8.
    1. Paques M, Massin P, Blain P, Duquesnoy AS, Gaudric A. Long-term incidence of reopening of macular holes. Ophthalmology. 2000 Apr;107(4):760-5; discussion 766.
    1. Yamashita T, Sakamoto T, Yamashita T, Sonoda S, Yamakiri K, Otsuka H, Hisatomi T, Imaki H, Ishibashi T, Dugel PU. Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery: minimizing treatment burden and maximizing outcome. Retina. 2014 Jul;34(7):1367-75.
    1. Wirbelauer C, Kolarov D, Just A. [Influence of Macular Hole Width on Visual Acuity, Endotamponade and Closure Rate]. Klin Monbl Augenheilkd. 2016 Dec;233(12):1362-1366.
    1. Gass JD. Idiopathic senile macular hole: its early stages and pathogenesis. 1988. Retina. 2003 Dec;23(6 Suppl):629-39.
    1. Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, Sadda SR, Sebag J, Spaide RF, Stalmans P. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013 Dec;120(12):2611-2619.
    1. Ullrich S, Haritoglou C, Gass C, Schaumberger M, Ulbig MW, Kampik A. Macular hole size as a prognostic factor in macular hole surgery. Br J Ophthalmol. 2002 Apr;86(4):390-3.
    1. Kusuhara S, Teraoka Escaño MF, Fujii S, Nakanishi Y, Tamura Y, Nagai A, Yamamoto H, Tsukahara Y, Negi A. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes. Am J Ophthalmol. 2004 Nov;138(5):709-16.
    1. Ruiz-Moreno JM, Staicu C, Piñero DP, Montero J, Lugo F, Amat P. Optical coherence tomography predictive factors for macular hole surgery outcome. Br J Ophthalmol. 2008 May;92(5):640-4.
    1. Dai YM, Shen J, Li JK, Jin XH, Li YM. [Optical coherence tomography predictive factors for idiopathic macular hole surgery outcome]. Zhonghua Yan Ke Za Zhi. 2013 Sep;49(9):807-11.
    1. Shahlaee A, Rahimy E, Hsu J, Gupta OP, Ho AC. Preoperative and postoperative features of macular holes on en face imaging and optical coherence tomography angiography. Am J Ophthalmol Case Rep. 2017 Apr;5:20-25.
    1. Chen GH, Tzekov R, Jiang FZ, Mao SH, Tong YH, Li WS. Iatrogenic retinal breaks and postoperative retinal detachments in microincision vitrectomy surgery compared with conventional 20-gauge vitrectomy: a meta-analysis. Eye (Lond) 2019 May;33(5):785-795.
    1. Li SS, You R, Li M, Guo XX, Zhao L, Wang YL, Chen X. Internal limiting membrane peeling with different dyes in the surgery of idiopathic macular hole: a systematic review of literature and network Meta-analysis. Int J Ophthalmol. 2019;12(12):1917-1928.
    1. Unsal E, Cubuk MO, Ciftci F. Preoperative prognostic factors for macular hole surgery: Which is better? Oman J Ophthalmol. 2019 Jan-Apr;12(1):20-24.
    1. Kang SW, Ahn K, Ham DI. Types of macular hole closure and their clinical implications. Br J Ophthalmol. 2003 Aug;87(8):1015-9.
    1. Park SS, Marcus DM, Duker JS, Pesavento RD, Topping TM, Frederick AR, D'Amico DJ. Posterior segment complications after vitrectomy for macular hole. Ophthalmology. 1995 May;102(5):775-81.
    1. Rizzo S, Belting C, Genovesi-Ebert F, di Bartolo E. Incidence of retinal detachment after small-incision, sutureless pars plana vitrectomy compared with conventional 20-gauge vitrectomy in macular hole and epiretinal membrane surgery. Retina. 2010 Jul-Aug;30(7):1065-71.
    1. Guillaubey A, Malvitte L, Lafontaine PO, Hubert I, Bron A, Berrod JP, Creuzot-Garcher C. Incidence of retinal detachment after macular surgery: a retrospective study of 634 cases. Br J Ophthalmol. 2007 Oct;91(10):1327-30.
    1. Runkle AP, Srivastava SK, Yuan A, Kaiser PK, Singh RP, Reese JL, Ehlers JP. FACTORS ASSOCIATED WITH DEVELOPMENT OF DISSOCIATED OPTIC NERVE FIBER LAYER APPEARANCE IN THE PIONEER INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY STUDY. Retina. 2018 Sep;38 Suppl 1(Suppl 1):S103-S109.
    1. Spaide RF. "Dissociated optic nerve fiber layer appearance" after internal limiting membrane removal is inner retinal dimpling. Retina. 2012 Oct;32(9):1719-26.
    1. Tadayoni R, Svorenova I, Erginay A, Gaudric A, Massin P. Decreased retinal sensitivity after internal limiting membrane peeling for macular hole surgery. Br J Ophthalmol. 2012 Dec;96(12):1513-6.
    1. Paques M, Massin P, Santiago PY, Spielmann AC, Gaudric A. Visual field loss after vitrectomy for full-thickness macular holes. Am J Ophthalmol. 1997 Jul;124(1):88-94.
    1. Ezra E, Arden GB, Riordan-Eva P, Aylward GW, Gregor ZJ. Visual field loss following vitrectomy for stage 2 and 3 macular holes. Br J Ophthalmol. 1996 Jun;80(6):519-25.
    1. Welch JC. Dehydration injury as a possible cause of visual field defect after pars plana vitrectomy for macular hole. Am J Ophthalmol. 1997 Nov;124(5):698-9.
    1. Christmas NJ, Smiddy WE, Flynn HW. Reopening of macular holes after initially successful repair. Ophthalmology. 1998 Oct;105(10):1835-8.
    1. Rahimy E, McCannel CA. IMPACT OF INTERNAL LIMITING MEMBRANE PEELING ON MACULAR HOLE REOPENING: A Systematic Review and Meta-Analysis. Retina. 2016 Apr;36(4):679-87.
    1. Paques M, Massin P, Santiago PY, Spielmann AC, Le Gargasson JF, Gaudric A. Late reopening of successfully treated macular holes. Br J Ophthalmol. 1997 Aug;81(8):658-62.
    1. Knight D, Yu JJ, Adrean SD. RELAXING NASAL RETINOTOMY TECHNIQUE FOR CLOSURE OF A MACULAR HOLE THAT REOPENED AFTER PRIMARY VITRECTOMY. Retin Cases Brief Rep. 2021 Sep 01;15(5):611-614.
    1. Rao X, Wang NK, Chen YP, Hwang YS, Chuang LH, Liu IC, Chen KJ, Wu WC, Lai CC. Outcomes of outpatient fluid-gas exchange for open macular hole after vitrectomy. Am J Ophthalmol. 2013 Aug;156(2):326-333.e1.
    1. Holekamp NM, Meredith TA, Landers MB, Snyder WB, Thompson JT, Berman AJ, Williams S. Ulnar neuropathy as a complication of macular hole surgery. Arch Ophthalmol. 1999 Dec;117(12):1607-10.
    1. Fahim AT, Khan NW, Johnson MW. Acute panretinal structural and functional abnormalities after intravitreous ocriplasmin injection. JAMA Ophthalmol. 2014 Apr 01;132(4):484-6.
    1. Zandi S, Freiberg F, Vaclavik V, Pfister IB, Traine PG, Kaya C, Michels S, Garweg JG. Morphological Reconstitution and Persistent Changes After Intravitreal Ocriplasmin for Vitreomacular Traction and Macular Hole. J Ocul Pharmacol Ther. 2020 Mar;36(2):126-132.
    1. Florent C, Coupier L, Mérité PY, Meyer F, Guigou S. Human amniotic membrane plug technique for macular hole surgery: A case report. J Fr Ophtalmol. 2020 Apr;43(4):e151-e152.
    1. Caporossi T, Pacini B, De Angelis L, Barca F, Peiretti E, Rizzo S. HUMAN AMNIOTIC MEMBRANE TO CLOSE RECURRENT, HIGH MYOPIC MACULAR HOLES IN PATHOLOGIC MYOPIA WITH AXIAL LENGTH OF ≥30 mm. Retina. 2020 Oct;40(10):1946-1954.
    1. Lai CC, Chen YP, Wang NK, Chuang LH, Liu L, Chen KJ, Hwang YS, Wu WC, Chen TL. Vitrectomy with Internal Limiting Membrane Repositioning and Autologous Blood for Macular Hole Retinal Detachment in Highly Myopic Eyes. Ophthalmology. 2015 Sep;122(9):1889-98.
    1. Kapoor KG, Khan AN, Tieu BC, Khurshid GS. Revisiting autologous platelets as an adjuvant in macular hole repair: chronic macular holes without prone positioning. Ophthalmic Surg Lasers Imaging. 2012 Jul 01;43(4):291-5.
    1. Zhang X, Liu J, Yu B, Ma F, Ren X, Li X. Effects of mesenchymal stem cells and their exosomes on the healing of large and refractory macular holes. Graefes Arch Clin Exp Ophthalmol. 2018 Nov;256(11):2041-2052.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner