Macular holes develop earlier in high myopes, study finds

SAGA, Japan — Macular holes develop earlier in people with high myopia, according to a prospective study here. The degree of myopia did not, however, influence the size and surgical outcomes of the holes in the study.

Researchers here at the Saga Medical School enrolled 94 eyes of 91 patients with stage 3 or stage 4 idiopathic macular hole in the prospective study. Age at onset of the macular hole showed a significant increase in relation to myopic refraction and axial length (P < .0001).

In eyes with an axial length of 26 mm and longer, the mean age of the patient at onset was 51. In eyes with axial lengths between 23 mm and 25.99 mm, the mean age was 65. In eyes whose axial lengths were shorter than 23 mm, the median age of the patient was 70 years.

In patients with stage 3 macular holes, the mean area of the macular hole was 0.291 mm² in eyes with axial lengths longer than 26 mm. Eyes with axial lengths between 23 mm and 25.99 mm had mean macular hole areas of 0.283 mm². Eyes with axial lengths shorter than 23 mm had mean macular hole sizes of 0.296 mm². No significant differences were found in area, volume and depth of the macular holes, and area of cuff and retinal striae were not significantly different among the three groups either.

Overall anatomical success rate and visual improvement in eyes with stage 3 macular holes was 100% in the eyes with the longest axial lengths, 100% in the eyes with mid-range axial lengths and 95% in eyes with the shortest axial lengths. There was no statistically significant difference.

The study is published in the November issue of British Journal of Ophthalmology.