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Size and vitreomacular attachment of primary full-thickness macular holes
  1. Elise Philippakis,
  2. Franck Amouyal,
  3. Aude Couturier,
  4. Elise Boulanger-Scemama,
  5. Alain Gaudric,
  6. Ramin Tadayoni
  1. Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7-Sorbonne Paris Cité, Paris, France
  1. Correspondence to Dr Elise Philippakis, Department of Ophthalmology, Hôpital Lariboisière, 2 rue Ambroise Paré, Paris 75010, France; elise.philippakis{at}


Purpose To study the relationship between the size of primary full-thickness macular hole (MH) and the vitreomacular attachment status.

Design Single-centre retrospective observational case series.

Methods The records of 100 consecutive eyes operated for primary full-thickness MH were retrospectively reviewed. The vitreous status and MH diameter were assessed on the preoperative optical coherence tomography scans. MH were classified depending on the presence or absence of vitreomacular traction (VMT) and their size as small (<250 µm), medium (250–400 µm) and large (>400 µm), as suggested in the International VMT Study Group Classification.

Results 22% of MH had VMT and 13% had both VMT and a diameter <400 µm. The MH diameter was not significantly different depending on the presence or absence of VMT (respectively, 339±134 and 423±191 µm (p=0.094)), with large overlap between groups. Small, medium and large MH were similarly distributed regardless of the presence or absence of VMT (p=0.69).

Conclusions Our series of 100 MH did not reveal any significant relationship between the MH size and the presence or absence of VMT. Only 13% of MH had VMT and a diameter <400 mm, then were eligible for intravitreal ocriplasmin as a possible treatment.

  • Vitreous
  • Retina
  • Imaging
  • Macula

Statistics from


  • Contributors EP, AC and RT designed the study and operated on patients. EP and FA performed the statistical analysis and wrote the first draft of the manuscript. AC and EB-S collected patient data. RT and AG contributed in the manuscript reviewing process.

  • Competing interests EP: travel expenses (Novartis, Bayer, Allergan). EB-S: travel expenses (Bayer). AG: board membership (Alimera, Allergan, Thrombogenics), lectures (Heidelberg, Zeiss) and educational presentations (Novartis, Alcon). RT: board membership (Alcon, Novartis, Allergan, Bausch & Lomb, Pfizer, Alimera, Bayer, Zeiss, FCI, Genentech, Roche, Thrombogenics) and travel expenses (Novartis, Bayer, Allergan).

  • Ethics approval Ethics Committee of the French Society of Ophthalmology (IRB 00008855 Société Française d'Ophtalmologie IRB#1).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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