Macular hole formation in fellow eyes with a perifoveal posterior vitreous detachment of patients with a unilateral macular hole

Abstract

Purpose: To estimate the rate of macular hole formation in fellow eyes with a perifoveal posterior vitreous detachment (PVD) and early stage 1 intrafoveal lesions in patients with a unilateral idiopathic full-thickness macular hole (MH) using optical coherence tomography (OCT).

Design: Retrospective observational case series.

Methods: Fellow eyes of consecutive patients with a unilateral full-thickness MH were examined on OCT. A subset of fellow eyes with a perifoveal PVD had been followed to investigate the rates of macular hole formation in fellow eyes with early stage 1 intrafoveal lesions.

Results: Of 176 patients with a unilateral full-thickness MH, 42 fellow eyes (42 patients) with a perifoveal PVD were identified. During follow-up, a foveolar detachment was seen in 16 eyes, and 4 eyes had a foveal pseudocyst alone. In the 16 eyes with a foveolar detachment, 9 eyes had concurrent inner foveal splits. Within another 2 years of follow-up, OCT showed that 5 of 16 fellow eyes (31%) with a foveolar detachment developed a second full-thickness MH and 5 of 9 fellow eyes with a foveolar detachment and inner foveal splits developed a second full-thickness MH. Two of 4 eyes with a foveal pseudocyst alone developed vitreofoveal separation without hole formation. The remaining 2 eyes with a foveal pseudocyst alone remained stable at the last follow-up visit.

Conclusions: Fellow eyes with a foveolar detachment and a perifoveal PVD may be at high risk, and fellow eyes with a foveolar detachment and inner foveal splits might be at higher risk for progression to macular hole formation.