This article is more than 5 years old. Information may no longer be current.
Macular hole best managed early
Click Here to Manage Email Alerts
SAN DIEGO — Optimal management of macular holes has long been debated, but some conclusions can be made, according to a speaker at the American Society of Retina Specialists annual meeting.
Ron Adelman, MD, MPH, FACS, who presented results from the European Vitreoretinal Society Macular Hole Study, said despite the number of variables regarding technique and management among the 140 participating retina specialists in 28 countries, hole closure was achieved in 85.7% of 4,207 macular hole cases after more than 1 year of follow-up.
Ron Adelman
“Predictors of hole closure included lower-stage, shorter hole duration and use of stain,” Adelman said. “The frequency of hole closure, as expected, is higher in lower stages, and the shorter the duration of the hole, the best outcome. The best outcome was in the first month after the diagnosis of hole.”
Use of stain yielded a higher closure rate, but there was no statistically significant difference among types of stain used, including brilliant blue, trypan blue and indocyanine green, Adelman said. Furthermore, use of dye neither improved nor limited visual outcomes.
The take-home message is that dye improves anatomical success but not visual success,” he said.
On the question of whether face-down positioning is necessary, Adelman said long-term positioning may not be necessary.
After surgery, best corrected visual acuity continued to improve for a year, according to Adelman.
Disclosure: Adelman has no relevant financial disclosures.