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Clinical characteristics of full thickness macular holes that closed without surgery
  1. Sami H Uwaydat1,
  2. Ahmad Mansour2,3,
  3. Francisco J Ascaso4,5,
  4. Maurizio Battaglia Parodi6,
  5. Robert Foster7,
  6. William E Smiddy8,
  7. Stephen G Schwartz9,
  8. Abdulrazzak Charbaji10,11,
  9. Silvana Belotto12,
  10. Ignasi Jürgens12,
  11. Javier Mateo4,
  12. Abdallah A Ellabban13,14,
  13. Lihteh Wu15,
  14. Marta Figueroa16,
  15. Nuria Olivier Pascual17,
  16. Luiz H Lima18,
  17. Wael A Alsakran19,
  18. Sibel Caliskan Kadayifcilar20,
  19. Suthasinee Sinawat21,
  20. Alexandre Assi22,
  21. Hana A Mansour23,
  22. Antonio Marcello Casella24,
  23. Amparo Navea25,
  24. Elena Rodríguez Neila26,
  25. A Osman Saatci27,
  26. Vishal Govindahari28,
  27. Olivia Esteban Floria29,30,
  28. Komal Agarwal31,
  29. Ismael Bakkali El Bakkali4,
  30. Angel Salinas Alaman32,
  31. Sofia Fernandez Larripa33,
  32. Amanda Rey34,
  33. Patricia Pera35,
  34. Lluís Bruix12,
  35. Lorenzo Lopez-Guajardo36,
  36. Eduardo Pérez-Salvador37,
  37. Francisco Javier Lara Medina38,
  38. Frank N Hrisomalos39,
  39. Jay Chhablani40,
  40. J Fernando Arevalo41
  1. 1Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  2. 2Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
  3. 3Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon
  4. 4Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  5. 5Department of Ophthalmology, University of Zaragoza, Zaragoza, Spain
  6. 6Department of Ophthalmology, University of Udine, Udine, Italy
  7. 7Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
  8. 8Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USA
  9. 9Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, Florida, USA
  10. 10Research and Applied Statistics, Lebanese American University, Beirut, Lebanon
  11. 11Research and Applied Statistics, CHARBAJI Consultants, Beirut, Lebanon
  12. 12Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
  13. 13Department of Ophthalmology, Hull University Teaching Hospitals, Hull, Yorkshire, UK
  14. 14Department of Ophthalmology, Suez Canal University, Faculty of Medicine, Ismailia, Egypt
  15. 15Department of Ophthalmology, Apdo 144-1225 Plaza Mayor, San Jose, Costa Rica
  16. 16Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain
  17. 17Ophtahlmology, Área Sanitaria de Ferrol, Ferrol, Spain
  18. 18Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  19. 19Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
  20. 20Ophthalmology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
  21. 21Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
  22. 22Department of Ophthalmology, Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon
  23. 23Ophthalmology, American University of Beirut, Beirut, Lebanon
  24. 24Ophthalmology, Universidade Estadual de Londrina, Londrina, Brazil
  25. 25Department of Ophthalmology, Instituto de la Retina, Valencia, Spain
  26. 26Department of Ophthalmology, H U Juan Ramón Jiménez, Huelva, Spain
  27. 27Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
  28. 28LV Prasad Eye Institute, Bhunaneswar, Hyderabad, India
  29. 29Ophthalmology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
  30. 30Department of Ophthalmology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
  31. 31Department of Ophthalmology, LV Prasad Eye Institute, Hyderabad, Telangana, India
  32. 32Department of Ophthalmology, Clinica Universida de Navarra, Madrid, Spain
  33. 33Department of Ophthalmology, Hospital Universitario Miguel Servet, Zaragoza, Spain
  34. 34Department of Ophthalmology, Hospital Clinic, Barcelona, Spain
  35. 35Department of Ophthalmology, Institut Català de Retina SL, Barcelona, Spain
  36. 36Ophthalmology, University Hospital Principe de Asturias, Alcala de Henares, Spain
  37. 37Department of Ophthalmology, Hospital Universitario de Burgos, Burgos, Spain
  38. 38Ophthalmology, La Mancha-Centro Hospital, Alcázar de San Juan, Ciudad Real, Spain
  39. 39Department of Ophthalmology, Indiana University, Indianapolis, Indiana, USA
  40. 40UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  41. 41Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Ahmad Mansour, Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; ammansourmd{at}gmail.com

Abstract

Purpose To ascertain the anatomic factors that help achieve non-surgical sealing in full thickness macular hole (FTMH).

Methods Retrospective collaborative study of FTMH that closed without surgical intervention.

Results A total of 78 patients (mean age 57.9 years) included 18 patients with blunt ocular trauma, 18 patients that received topical or intravitreal therapies and 42 patients with idiopathic FTMH. Mean±SD of the initial corrected visual acuity (VA) in logMAR improved from 0.65±0.54 to 0.34±0.45 (p<0.001) at a mean follow-up of 33.8±37.1 months. FTMH reopened in seven eyes (9.0%) after a mean of 8.6 months. Vitreomacular traction was noted in 12 eyes (15.8%), perifoveal posterior vitreous detachment in 42 (53.8%), foveal epiretinal membrane in 10 (12.8%), cystoid macular oedema (CME) in 49 (62.8%) and subretinal fluid (SRF) in 20 (25.6%). By multivariate analysis, initial VA correlated to the height (p<0.001) and narrowest diameter of the hole (p<0.001) while final VA correlated to the basal diameter (p<0.001). Time for closure of FTMH (median 2.8 months) correlated to the narrowest diameter (p<0.001) and the presence of SRF (p=0.001). Mean time for closure (in months) was 1.6 for eyes with trauma, 4.3 for eyes without trauma but with therapy for CME, 4.4 for eyes without trauma and without therapy in less than 200 µm in size and 24.7 for more than 200 µm.

Conclusion Our data suggest an observation period in new onset FTMH for non-surgical closure, in the setting of trauma, treatment of CME and size <200 µm.

  • Macula
  • Retina
  • Trauma
  • Treatment Medical

Data availability statement

Data are available upon reasonable request. Data are available upon request by email to the corresponding author.

Statistics from Altmetric.com

Data availability statement

Data are available upon reasonable request. Data are available upon request by email to the corresponding author.

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Footnotes

  • Twitter @AMPARONAVEA

  • Contributors SHU and AM contributed to design of the study, data analysis, manuscript draft. AC contributed to statistical analysis and manuscript revision. All authors contributed to data acquisition and manuscript revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement statement Patient and public were not involved in conduct of the study

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

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