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Vitreous detachment, lesions in fellow eye increase risk for macular hole formation

Am J Ophthalmol. 2011;151(6):981-989.

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In patients with a unilateral full-thickness macular hole, fellow eyes with a foveolar detachment, perifoveal posterior vitreous detachment or inner foveal splits may have an increased risk for progression to macular hole, according to a study.

The retrospective observational case series included 176 patients with a unilateral full-thickness macular hole. Forty-two fellow eyes of 42 patients were found to have a perifoveal posterior vitreous detachment.

After an average follow-up of 18.2 ± 13 months, 16 eyes had a foveolar detachment, of which nine had concurrent inner foveal splits. Four eyes had a foveal pseudocyst only, the study said.

After 2 years of additional follow-up, a second full-thickness macular hole was observed in five of 16 fellow eyes with a foveolar detachment and five of nine fellow eyes with a foveolar detachment and inner foveal splits.

Of the four eyes with a foveal pseudocyst, two developed vitreofoveal separation without hole formation, and two eyes remained stable, the study said.