New onset full thickness macular holes, especially those that are a result of blunt ocular trauma, could close spontaneously without requiring macular hole surgery. This could also apply to other macular hole cases, based on the holes characteristics.

Investigators from numerous centres throughout the world collaborated on a retrospective study of full thickness macular holes, identifying anatomic factors that could result in spontaneous closing without surgical interventions. In the past the treatment for macular holes has been a vitrectomy, which involves a fluid-gas exchange and an limiting membrane pealing. Several reports have shown that these holes could close without surgery in approximately one in four patients.

In this study, macular hole closure was defined as a flattened and reattached hole rim along the circumference of the hole. The full thickness macular holes in the study were diagnosed using OCT that sealed without follow up surgery. They were classified as traumatic or idiopathic.

Seventy eight eyes in seventy eight patients had full thickness macular holes with eighteen sustaining blunt ocular trauma and eighteen were treated with topical or intravitreal therapies. After hole closure, the logarithm of minimal angle of resolution corrected visual acuity at 33.8 months was improved from 0.65 to 0.34, a significant difference.

Ray Man, the PA for Mahi Muqit, a leading consultant ophthalmologist in London, said “The full thickness macular holes closed in seventy four eyes with two having subretinal fluid and two having outer retinal defects that persisted in the follow up examinations. Eighteen patients chose not to have surgery, taking advantage of non surgical treatments. Four patients included treatment with intravitreal vascular endothelium growth factor antagonists and thirteen received topical corticosteroid. Seven received anti-inflammatory medications.”

The time to closure in the full thickness macular holes was around 2.8 months. Though the time to hole closure did vary based on numerous factors. For blunt trauma the hole closure times was 1.6 months and eyes without trauma receiving therapy for cystoid macular oedema was 4.3 months. Those without trauma or therapy took approximately 4.4 months to close.

The study showed that it is not unreasonable to observe recent macular holes for non surgical closure, especially in those that experienced blunt ocular trauma.

About Us:

Mahi Muqit is a leading consultant ophthalmologist, cataract and vitreoretinal surgeon at two private clinics in London, United Kingdom. He provides patients with superior service and support with a range of surgical procedures to meet their eye sight requirements. He has built up a solid reputation for his eye services in the London area as an expert eye doctor and surgeon offering surgical retina, medical retina and complex cataract surgery. He also offers surgery to patients suffering from diabetic retinopathy. Mahi Muqit is a member of the Royal College of Ophthalmologists, a member of the British and Eire Association of Vitreoretinal Surgeons and the UK and Ireland Society of Cataract and Refractive Surgeons. To find out more, visit https://www.retinasurgeon.uk.com/.