Types of macular hole closure and their clinical implications
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to: Se Woong Kang, MD, Department of Ophthalmology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, #50 Ilwon-dong, Kangnam-ku, Seoul, 135–230, Korea; swkang{at}smc.samsung.co.kr
- Accepted 3 December 2002
Abstract
Aims: To evaluate the clinical significance of macular hole closure types assessed by optical coherence tomography (OCT).
Methods: This study involved 34 eyes of 32 patients who had undergone anatomically successful idiopathic macular hole surgery. The closed macular holes were categorised into two patterns based on OCT; type 1 closure (closed without foveal neurosensory retinal defect) and type 2 closure (closed with foveal neurosensory retinal defect). Association between visual prognosis, type of hole closure, and possible prognostic factors were analysed.
Results: 19 eyes (61.3%) were classified into the type 1 closure and 12 eyes (38.7%) into the type 2 closure. The extent of postoperative visual improvement of type 1 closure group was larger than that of type 2 closure group (p=0.002). The preoperative macular hole size of type 2 closure group was significantly larger than that of type 1 closure group (p=0.006). The duration of symptoms was positively correlated with the preoperative macular hole size (p=0.01). Recurrence of macular hole occurred only in the type 2 closure group.
Conclusion: The type of macular hole closure, which was influenced by the preoperative hole diameter, was associated with postoperative visual prognosis. Early detection and intervention in macular hole should be emphasised.
