Topic
Macular hole
About: Macular hole is a research topic. Over the lifetime, 3803 publications have been published within this topic receiving 83462 citations. The topic is also known as: Macular Hole & Macular hole (disorder).
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TL;DR: Optical coherence tomography is potentially a powerful tool for detecting and monitoring a variety of macular diseases, including macular edema, macular holes, and detachments of the neurosensory retina and pigment epithelium.
1,278 citations
TL;DR: Clinical observations indicate that the treatment of macular holes by vitrectomy may offer some promise for this otherwise untreatable condition, and in patients in whom reattachment was successful, the technique used appeared to allow for clinically significant improvements in visual acuity.
Abstract: • Idiopathic macular holes are generally considered an untreatable condition. We used modern vitrectomy techniques to evaluate two questions: (1) Is it possible to reattach the retina around the macular hole? (2) If it is reattached, will the patient's central vision improve? In 30 (58%) of 52 patients, we were able to reattach successfully the detached macula with our surgical procedure. In 22 (73%) of the 30 patients in whom the macula was successfully reattached, there was an improvement in visual acuity of two lines or better. In the 22 patients in whom reattachment of the macular hole was not obtained, there was no significant improvement in visual acuity. Thus, the overall success rate for improved vision postoperatively was 42% (22/52). Complications related to surgery were observed in eight patients (15%) early in our experience with this procedure and included increase in the size of the macular hole, mottling of the retinal pigmented epithelium, and a vascular occlusion. Our clinical observations indicate that the treatment of macular holes by vitrectomy may offer some promise for this otherwise untreatable condition. In patients in whom reattachment was successful, the technique used appeared to allow for clinically significant improvements in visual acuity. However, additional work on increasing surgical success and minimizing surgical complications, as well as a further understanding of the mechanism of retinal reattachment, is required before widespread use of this procedure for treating macular holes.
1,116 citations
TL;DR: Evidence is presented that idiopathic senile macular hole is caused by focal shrinkage of the vitreous cortex in the foveal area and the clinical value of surgical peeling in eyes with stage 1 changes as a means of preventing hole formation is tested.
Abstract: Evidence is presented that idiopathic senile macular hole is caused by focal shrinkage of the vitreous cortex in the foveal area. The most reliable biomicroscopic signs of impending hole formation (stage 1) are the development of a yellow spot or ring in the center of the fovea, loss of the foveal depression, and no evidence of separation of the vitreous from the foveal retina. Although in a majority of eyes with stage 1 changes there is a progression to hole formation, spontaneous separation of the vitreous without hole formation may occur in some cases (44%) and cause characteristic biomicroscopic changes, including foveal reattachment, disappearance of the yellow spot or ring, and, in some cases, a pseudo-operculum, with one or more lamellar holes or facets. A prospective collaborative study is recommended to confirm these findings and to test the clinical value of surgical peeling of the vitreous cortex in eyes with stage 1 changes as a means of preventing hole formation.
937 citations
TL;DR: This classification system will support systematic diagnosis and management by creating a clinically applicable system that is predictive of therapeutic outcomes and is useful for the execution and analysis of clinical studies.
822 citations
TL;DR: In this paper, the change from a yellow spot to a yellow ring (stage 1-A) during the early stages of foveal detachment is unique to patients at risk of age-related macular hole and provides explanations for the remarkable recovery of visual acuity that occurs in some patients after vitreous surgery.
671 citations