To describe the clinical and optical coherence tomography findings associated with the development of full-thickness macular holes after rhegmatogenous retinal detachment (RRD) repair.
Retrospective, interventional case series. All patients who developed full-thickness macular holes after successful RRD repair from 3 clinical practices were reviewed. All cases of combined/simultaneous full-thickness macular hole and RRD were excluded. The main outcome measure was the presence of an epiretinal membrane at time of diagnosis of macular hole.
Twenty-five full-thickness macular holes were diagnosed after successful retinal detachment repair. Surgical approach to RRD repair included pneumatic retinopexy (6, 24%), scleral buckle alone (5, 20%), pars plana vitrectomy only (8, 32%), and combined scleral buckle and pars plana vitrectomy (6, 24%). The preceding RRD involved the macula in 19 patients (76%) before the formation of the macular hole. The median time to full-thickness macular hole diagnosis after RRD repair was 63 days (range, 4–4,080 days). An epiretinal membrane was present in all 25 (100%) macular holes. Two macular holes (8%) spontaneously closed, whereas the other 23 (92%) were successfully closed with a single surgical procedure. Mean visual acuity improved by approximately 5 lines to 20/72 (range, 20/20 to counting fingers at 1 foot) from 20/240 (range, 20/30 to hand motions) after macular hole repair (P < 0.0001).
Full-thickness macular hole formation can occur after all types of RRD repair and is associated with an epiretinal membrane. The epiretinal membrane may play a role in the pathogenesis of secondary macular hole formation after RRD repair.
In this retrospective, interventional case series, 25 full-thickness macular holes were diagnosed after successful retinal detachment repair. All 25 (100%) macular holes were associated with an epiretinal membrane. The epiretinal membrane may play a role in the pathogenesis of secondary macular hole formation after retinal detachment repair.
*Northern California Retina Vitreous Associates, Mountain View, California;
†Department of Ophthalmology, University of California, San Francisco, San Francisco, California;
‡Retina Consultants of Houston, Houston, Texas;
§Blanton Eye Institute, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas;
¶Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; and
**Celgene Corporation, Berkeley Heights, New Jersey.
Reprint requests: Charles C. Wykoff, MD, PhD, 6560 Fannin Street, Suite 750, Houston, TX 77030; e-mail: firstname.lastname@example.org
None of the authors have any financial/conflicting interests to disclose.