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Prevalence and Surgical Outcomes of Macular Hole in Eyes with Age-Related Macular Degeneration

Published:December 01, 2016DOI:https://doi.org/10.1016/j.oret.2016.09.014

      Purpose

      To report the prevalence and surgical outcomes of macular holes (MHs) in eyes with age-related macular degeneration (AMD).

      Design

      Interventional, retrospective, consecutive case series.

      Participants

      Patients with MH and concurrent non-neovascular (NNV) or neovascular (NV) AMD.

      Methods

      The records of 27 912 patients diagnosed with AMD between 2009 and 2014 at Associated Retinal Consultants were reviewed. Demographic data, visual acuity (VA), funduscopic examination, and optical coherence tomography were reviewed in those with a concurrent diagnosis of MH.

      Main Outcome Measures

      The VA and MH closure status.

      Results

      A total of 15 196 patients with NNV and 12 716 patients with NV AMD were identified. A total of 199 eyes (0.7%) had MHs (160 NNV [1.1%]; 39 NV [0.3%]). Mean time to diagnosis of MH after the initial visit was 11.2 months (7.1 NNV; 24.8 NV). A total of 127 eyes underwent surgical repair (106 NNV; 21 NV). The final closure rate in those who underwent vitrectomy was 89.8% (91.5% NNV; 81.0% NV) and 25.0% in those who were observed (18.5% NNV, P < 0.0001; 44.4% NV, P = 0.02). Preoperative logarithm of the minimum angle of resolution VAs in NNV and NV AMD was 0.8±0.4 and 0.8±0.5, respectively, and final VA was 0.6±0.5 (P < 0.001) and 0.9±0.6 (P = 0.52), respectively. Mean follow-up time was 5.0 years.

      Conclusions

      The prevalence of MH was higher in eyes with NNV AMD than in those with NV AMD. The surgical closure rate was comparable in both groups, but VA improvement reached statistical significance only in the NNV AMD group.

      Abbreviations and Acronyms:

      AMD (age-related macular degeneration), ERM (epiretinal membrane), FTMH (full-thickness macular hole), GA (geographic atrophy), ICG (indocyanine green), ILM (internal limiting membrane), logMAR (logarithm of the minimum angle of resolution), MH (macular hole), NNV (non-neovascular), NV (neovascular), OCT (optical coherence tomography), PVD (posterior vitreous detachment), RPE (retinal pigment epithelial), VA (visual acuity), VEGF (vascular endothelial growth factor), VMT (vitreomacular traction)
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