Macular Holes: Main Clinical Presentations, Diagnosis, and Therapies

Premi, Elias; Donati, Simone; Azzi, Lorenzo; Porta, Giovanni; Metrangolo, Cristian; Fontanel, Liviana; Morescalchi, Francesco; Azzolini, Claudio

doi:10.1155/2022/2270861

Cited by 14 publications

(13 citation statements)

References 99 publications

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“…There is no analogous case report in the literature, as most similar cases are treated surgically or are spontaneously closed during observation period. Contrary to the recommendations in the literature [ 11 ], we were forced to use conservative treatment since the parents refused surgical intervention. To our surprise, we discovered that while the macula did not improve anatomically, it may have improved functionally.…”

Section: Discussionmentioning

confidence: 95%

Eccentric Fixation and Good Visual Acuity in a Child with Large Traumatic Macular Hole: A Case Report

Asadigandomani,

Mohammadi,

Riazi-Esfahani

et al. 2023

Case Rep Ophthalmol

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A girl of 8 years old was referred to our clinic with a history of penetrating injury to her left eye 6 years ago with light perception vision and a large traumatic macular hole in her right eye. Her right eye’s vision was 4/10 when she first visited our clinic. Considering the patient’s one-eye status, her parents’ reluctance to undergo surgery, and the possibility of spontaneous closure of traumatic macular holes, it was determined to observe the patient and evaluate her visual acuity and macular hole condition. In 2 years, the final best corrected visual acuity was 8/10 in the right eye, with infratemporal eccentric fixation in visuoscopy. In addition to evaluating and reporting this case as a traumatic macular hole, we will discuss the role of nonsurgical treatment and the possibility of good visual acuity with eccentric fixation in a child with large traumatic macular hole.

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Section: Discussionmentioning

confidence: 95%

Eccentric Fixation and Good Visual Acuity in a Child with Large Traumatic Macular Hole: A Case Report

Asadigandomani,

Mohammadi,

Riazi-Esfahani

et al. 2023

Case Rep Ophthalmol

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“…В исследовании отмечена наибольшая связь показателей мфЭРГ с перфузией в Гкс в местах наличия интраретинальных кИ. считается, что субстратом для формирования кИ служат клетки Мюллера [10]. Однако точные механизмы развития кИ при ИсМР остаются дискутабельными: является ли кистообразование следствием накопления жидкости внутри клеток Мюллера из-за их дистрофических изменений или связано с проникновением жидкости в межклеточное пространство через края разрыва [11].…”

Section: Discussionunclassified

The effect of retinal perfusion on the bioelectric activity of the retina in full-thickness macular holes

Doktorova¹,

Suetov²,

Boiko³

et al. 2023

Ophthalmology Reports

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BACKGROUND: Information on retinal capillary perfusion in idiopathic full-thickness macular hole (FTMH) is limited, and there are no data on the possible effect of blood supply to individual areas and layers of the retina on their functional activity. AIM: To study the relationship between vascular perfusion in the superficial and deep capillary plexuses (SCP and DCP) and the bioelectrical activity of the retina in full-thickness macular hole. MATERIALS AND METHODS: Multifocal electroretinography (mfERG), optical coherence tomography (OCT), and OCT-angiography (OCTA) were performed in 18 eyes with FTMH and 10 intact eyes. In the projection of individual hexagons of the mfERG pattern, parameters of bioelectrical activity were compared with structural changes (hole, cystic changes), capillary density in the SCP and DCP. RESULTS: In the FTMH group, the density of capillaries in the superficial capillary plexuses correlated with P1 implicit time in the R2 ring hexagons (R = 0.23, p 0.05), in the hole zone and intraretinal cystic changes (R = 0.21 and R = 0.22, p 0.05), P1 amplitude in the hole zone (R = 0.24, p 0.05). In deep capillary plexuses, the capillary density correlated with N1 implicit time at the fixation point and the hole zone (R = 0.57 and R = 0.19, p 0.05), P1 implicit time at the hole zone (R = 0.2, p 0.05), P1 amplitude in the hexagons of the R2 and R3 rings (R = 0.46 and R = 0.44, p 0.05), more pronounced in the hole zone and cystic changes (R = 0.54 and R = 0.29, p 0.05). CONCLUSIONS: There is a correlation between capillary perfusion in different layers of the retina and its bioelectrical activity in FTMH. A decrease in perfusion in the deep capillary plexus of the macula with a chronic macular hole may be a predictor of a low functional prognosis in the outcome of surgical treatment of FTMH.

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“…With the progression of IMH, the best‐corrected visual acuity (BCVA) would typically decrease to 20/200 (Snellen), causing serious vision impairment 3 . Pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) and intravitreal gas tamponade is the standard treatment for IMH, with a high anatomical closure rate of 80–100% 4,5 . And ILMP is one of the key steps, which can remove the tangential traction exerted by ILM 6 .…”

Section: Introductionmentioning

confidence: 99%

“…3 Pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) and intravitreal gas tamponade is the standard treatment for IMH, with a high anatomical closure rate of 80-100%. 4,5 And ILMP is one of the key steps, which can remove the tangential traction exerted by ILM. 6 However, as the basal membrane of Müller cells, ILM plays a role in homeostasis and maintenance of inner retinal architecture.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the inner retinal layers following traditional and modified ILM peeling surgery using automatic CMDS quantification algorithm

Shen,

Ye,

et al. 2023

VIEW

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Idiopathic macular hole (IMH) is a vitreoretinal disease that causes severe visual impairment, and the pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) is the traditional treatment for IMH. Since the dissociated optical nerve fiber layer (DONFL) is observed in the eyes after the surgery, a modified surgery is put forward to minimize the injury. However, the extent to which the modified surgery reduced damage is not clear. A novel automated image processing system was developed in this study to quantify the damage after the surgery, revealing how the modified surgery reduced the DONFL. Optical coherence tomography (OCT) images and visual acuity were collected from 65 eyes that underwent a vitrectomy with traditional and modified ILM peeling procedure at Zhejiang Provincial People’s Hospital preoperatively. We found that DONFL occurred in all 65 eyes of both the traditional and modified ILM peeling groups. The concentric macular dark spots (CMDS) were automatically measured by the image processing system. The mean total area of CMDS was smaller in the modified ILM peeling group (0.224 ± 0.110 mm2) than that of the traditional ILM peeling group (0.385 ± 0.237 mm2), and there is a significant difference between the two groups (p < .05). The morphological difference in the temporal quadrant of CMDS between the two surgery technology groups was significant (p < .001). This study will provide a clinical research basis for the improvement of macular hole surgery.

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Macular Holes: Main Clinical Presentations, Diagnosis, and Therapies

Cited by 14 publications

References 99 publications

Eccentric Fixation and Good Visual Acuity in a Child with Large Traumatic Macular Hole: A Case Report

Eccentric Fixation and Good Visual Acuity in a Child with Large Traumatic Macular Hole: A Case Report

The effect of retinal perfusion on the bioelectric activity of the retina in full-thickness macular holes

Evaluation of the inner retinal layers following traditional and modified ILM peeling surgery using automatic CMDS quantification algorithm

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