Optical Coherence Tomographic Evaluation of Impending Idiopathic Macular Hole Repaired by Vitrectomy

ABSTRACT

PURPOSE: Pars plana vitrectomy has been suggested for the management of the early stages of idiopathic macular hole formation to relieve vitreofoveal traction. Also, the fellow eyes are at risk for the development of macular holes. The purpose of this report is to assess the benefit of vitreous surgery in preventing the development of macular hole of full-thickness from acutely symptomatic impending macular holes of stage 1. METHODS: In an attempt to prevent full-thickness macular hole formation. we performed pars plana vitrectomy and peeling of internal limiting membrane (ILM) in 3 eyes with signs and symptoms of stage 1 macular hole. All 3 eyes were symptomatic with recent reductions of visual acuities or changes in the macula believed to progress into macular holes detected by the optical coherence tomography (OCT). Also, full-thickness macular holes had already existed in the fellow eyes. RESULTS: All 3 eyes have not developed full-thickness macular holes for longer than 3 months within the follow -up periods after the operation, and the final visual acuities were improved as well. Normal foveal anatomies were attained from all eyes on the OCT. CONCLUSIONS: Vitrectomy and ILM removal as prophylactic therapy is a management option for acutely impending symptomatic macular holes, and the evaluation of vitreoretinal attachment by the OCT can provide useful information in determining operation.