Correlations Between Suspended Hyperreflective Material With the Macular Microstructure and Spontaneous Closure of Full-Thickness Macular Holes

Abstract

Purpose: To investigate the characteristics of spontaneously closed full-thickness macular holes (FTMHs) and to seek potential predictors for the spontaneous closure of FTMHs. Methods: In this retrospective cohort study, the clinical data and optical coherence tomography (OCT) images were reviewed from 19 eyes with spontaneously closed FTMHs (spontaneous closure group) and 37 control eyes with FTMHs that were delayed for non-medical reasons but ultimately requiring surgery (control group). The term, suspended hyperreflective material (SHM), was defined as hyperreflective material suspended within the FTMHs observed via OCT; the presence of SHM was evaluated in these eyes. Results: The median time from diagnosis to spontaneous closure of the FTMHs was 13.7 (range, 2.4-32.4) weeks in the spontaneous closure group. The mean diameter of FTMHs in the spontaneous closure group was significantly smaller than that in the control group (191.68±70.57 μm vs 401.68±162.19 μm, P<0.0001). The incidence of vitreomacular traction (VMT) was higher in the spontaneous closure group compared to the control group (9/19 vs 5/37, P=0.009, OR [95% CI], 5.76 [1.56–21.21]); in 7 of the 9 eyes with VMT from the spontaneous closure group, spontaneous VMT separation and subsequent FTMH closure was observed. SHM was observed in 9 eyes (47%) from the spontaneous closure group and 3 eyes (8%) from the control group (P=0.001, OR [95% CI], 10.20[2.31‒45.02]). Conclusions: Smaller diameters, VMT, and presence of SHM might be suggestive of the potential for spontaneous closure of FTMHs.