Two Cases of Macular Hole Closure with Topical Medical Treatment

Weber, Adrian; Suppiger, Tobias Sven; Hasler, Pascal W.

doi:10.1055/a-2040-4350

Cited by 1 publication

(1 citation statement)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Forty-nine studies had complete data with a total of 181 eyes forming the basis of our analysis [Table 2]. [ 18 ][ 19 ][ 20 ][ 21 ][ 22 ][ 23 ][ 24 ][ 25 , 26 , 27 , 28 ][ 29 ][ 30 ][ 31 ][ 32 ][ 33 ][ 34 ][ 35 ][ 36 ][ 37 ][ 38 ][ 39 ][ 40 ][ 41 ][ 42 ][ 43 ][ 44 ][ 45 ][ 46 ][ 47 ][ 48 ][ 49 ][ 50 ][ 51 ][ 52 ][ 53 ][ 54 ][ 55 ][ 56 ] Mean vision improved significantly ( P

0.005) from 20/65 to 20/41 over a mean follow-up of two years. The median diameter of IFTMH was 166 with 81.1% being categorized as small holes.…”

Section: Resultsmentioning

confidence: 99%

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

M Mansour,

Parodi,

H Uwaydat

et al. 2023

JOVR

View full text Add to dashboard Cite

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.

show abstract