![]() ![]() A careful history should be obtained to investigate for any of the risk factors mentioned above. Idiopathic MH occur with an estimated incidence of 8.69 eyes per 100,000 population per year in one study. Patients with MHs typically present over the age of 60 and females are more frequently affected. It is important to distinguish between a full-thickness macular hole versus a lamellar hole (irregular foveal contour with defect in the inner fovea) or pseudohole (an irregular foveal contour with steep edges without true absence of retinal tissue often associated with an epiretinal membrane). In some cases, optical coherence tomography (OCT) is useful in the diagnosis and management of this condition. This is a clinical diagnosis based on history and clinical exam, including slit lamp and dilated fundus examination. Pars plana vitrectomy has not been clearly demonstrated to be effective in preventing MH formation. There are no preventative measures for idiopathic MHs. MH have been implicated following anterior segment laser procedures which have been thought to be due to vitreoretinal traction. MHs are noted to be a complication of a posterior vitreous detachment (PVD) at its earliest stages. It has been hypothesized that MHs are caused by tangential traction as well as anterior posterior vitreoretinal traction of the posterior hyaloid on the parafovea. ![]() Cystoid edema in the outer plexiform and inner nuclear layers and thinning of the photoreceptor layer can also be observed. They are thought to cause tangential traction on the fovea. Residual cortical vitreous, retinal glial, and retinal pigment epithelial cells are often found on the retinal surface. Risk factors include age, female gender, myopia, trauma, or ocular inflammation.ĭifferent findings can be observed depending the stage of the MH. Idiopathic macular hole is the most common presentation. A macular hole (MH) is a retinal break commonly involving the fovea. ![]()
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