ABSTRACT
@#Idiopathic macular hole(IMH)refers to a full-thickness tissue defect of the retinal neuroepithelial layer in the macular region without obvious etiology. At present, with the gradual deepening of the understanding of IMH and the continuous innovation and improvement of its treatment methods, its treatment technology has also matured and diversified. Studies have shown that early IMH with small diameter can be observed and followed up. The Ocriplasmin has been approved for use in patients with small to medium sized macular holes and vitreomacular adhesion(VMA); internal limiting membrane(ILM)removal can improve anatomical closure rate. However, for IMH with a diameter of less than 250μm, it is uncertain whether ILM removal is always required. This paper discusses the pathogenesis, stages, classification and current treatment of IMH. Based on the characteristics of IMH and patient differences, an evidence-based medicine method is proposed to select the best and most practical treatment plan for individual patients.
ABSTRACT
Internal limiting membrane (ILM) peeling technique has been widely used in the treatment of a variety of vitreoretinal diseases for the advantage of releasing vitreomacular traction.However,this routine approach was less effective in refractory macular disorders.Meanwhile,the technique and the use of stains could lead to structural and functional changes of macular.Therefore,to better preserve macular structure,modified ILM peeling techniques including inverted ILM flap technique,autologous transplantation of ILM technique and the foveola nonpeeling ILM technique emerged.Recent researches had demonstrated favorable structural and functional outcomes of these techniques on giant macular hole,refractory macular hole and high myopic macular hole.However,more longterm follow-up studies with larger samples are needed to confirm the current results.In this paper,we reviewed the progress of modified ILM peeling technique in vitreoretinal diseases.