Long-term outcome of macular microstructure assessed by optical coherence tomography in eyes with spontaneous resolution of macular hole

Am J Ophthalmol. 2012 Apr;153(4):687-91. doi: 10.1016/j.ajo.2011.09.017. Epub 2012 Jan 14.

Abstract

Purpose: To evaluate the long-term anatomic features as assessed by optical coherence tomography (OCT) in patients with spontaneously closed full-thickness macular hole (MH).

Design: Retrospective, noncomparative, observational case series.

Methods: Six eyes of 6 patients who eventually showed spontaneous resolution of idiopathic MH were studied. The best-corrected visual acuity (BCVA) and OCT images of the fovea were examined before and until at least 3 years after spontaneous resolution.

Results: The MH closed spontaneously 1 to 4 months after the initial examination. There were 2 distinct macular abnormalities in the early period after spontaneous closure: 4 eyes showed outer foveal defects and the remaining 2 eyes showed persistent foveal detachment. However, the fovea regained its normal configuration and the photoreceptor inner segment/outer segment (IS/OS) junction recovered completely in all eyes. Although all 6 eyes showed visual improvement after the hole closure, the BCVA in the 4 eyes that showed delayed recovery of the IS/OS junction and foveal detachment was limited to 20/25 or worse.

Conclusion: Spontaneous closure of MH could acquire complete anatomic reconstruction. However, delayed restoration of the IS/OS junction and persistent foveal detachment after spontaneous closure might influence the functional outcomes.

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Remission, Spontaneous
  • Retina / pathology*
  • Retinal Perforations / physiopathology*
  • Retrospective Studies
  • Tomography, Optical Coherence*
  • Visual Acuity / physiology