Retinal displacement after closure of idiopathic macular hole

ABSTRACT

Objective:To study the foveal displacement during the closure of idiopathic macular holes (MHs).Methods:Thirty-seven idiopathic MH patients treated by pars plana vitrectomy and internal limiting membrane peeling were studied prospectively. Locations of MH center and foveal pit were measured by optic coherence tomography. Retinal displacement was observed using confocal scanning laser ophthalmoscopy.Results:A total of 40 eyes were included in this study and MHs were closed in 37 eyes (92.5%). The confocal scanning laser ophthalmoscopy showed that all of the retinal capillaries in the superior, inferior, nasal and temporal sides of the MHs moved toward the optic nerve head (ONH). The optic coherence tomography results showed that the mean nasal displacements of foveal pits were (102.9±61.2), (109.6±53.1), and (137.0±52.0) μm at 3, 6 and 12 months, respectively. And the mean vertical displacements were (55.9±49.4), (61.4±57.8) and (67.8±54.3) μm, respectively. Post-operative foveal pits were located in the nasal side of the MH centers. The extension of retina and nasal to the MH were in opposite directions the nasal hole margin moved toward the MH, but the retina located closer to the ONH moved toward the ONH. The fellow eyes of three patients developed into idiopathic MH during the follow-up period and operations were performed for all of the three patients.Conclusion:Our results showed that center of macula does not move when an idiopathic MH develops, but it moves toward ONH during closure of hole; thus, new fovea is in nasal side of original fovea.