The status of studies on the treatment and prognosis estimation in idiopathic macular hole_Chinese Journal of Ocular Fundus Diseases

Authors：

BaoQing ,  XingYiqiao

Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

XingYiqiao, Email: xing_yiqiao@aliyun.com

Keywords：

Retinal perforations/surgery; Vitreoretinal surgery; Retinal perforations/drug therapy; Tomography,optical coherence; Review

DOI：

10.3760/cma.j.issn.1005-1015.2016.05.028

Video：

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Abstract Full text Figures/Tables Video References Cited by

Idiopathic macular hole (IMH) refers to full thickness defects of retina in macular area with no clear reasons. The management of IMH includes vitrectomy combined with internal limiting membrane (ILM) peeling and pharmacological vitreolysis. But ILM peeling may damage the inner retina; novel techniques, such as inverted ILM flap technique and foveola non-peeling ILM surgery, autologous ILM transplantation had made the method of ILM peeling more diversified with less damage. Pharmacological vitreolysis targeting fibronectin and laminin is considered to work in a two-step mechanism, involving both vitreoretinal separation and vitreous liquefaction. Furthermore, IMH judgment and prognosis indicators like ellipsoid zone, macular hole index, hole formation factor, diameter hole index and tractional hole index based on spectral domain optical coherence tomography enriched the assessment of macular hole diameter, depth and shape. How to make full use of new interventions to reduce the incidence of macular hole and obtain a better visual acuity with closed holes is an important direction for future research.

Citation： BaoQing, XingYiqiao. The status of studies on the treatment and prognosis estimation in idiopathic macular hole. Chinese Journal of Ocular Fundus Diseases, 2016, 32(5): 549-553. doi: 10.3760/cma.j.issn.1005-1015.2016.05.028 Copy

1.	Gass JD. Idiopathic senile macular hole:its early stages and pathogenesis[J].Arch Ophthalmol, 2004, 23(6):629-639. DOI:10.1001/archopht.1988.01060130683026.
2.	Guyer DR, Green WR. Idiopathic macular holes and precursor lesions[M]//Franklin RM. Retina and vitreous. Amsterdam:Kugler Publications, 1993:135-162.
3.	Kwok AK, Li WW, Pang CP, et al. Indocyanine green staining and removal of internal limiting membrane in macular hole surgery:histology and outcome[J]. Am J Ophthalmol, 2001, 132(2):178-183.
4.	Spaide RF. Macular hole hypotheses[J].Am J Ophthalmol, 2005, 139(1):149-151. DOI:10.1016/j.ajo.2004.09.027.
5.	Woon WH, Greig D, Savage MD, et al. Asymmetric vitreomacular traction and symmetrical full thickness macular hole formation[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(11):1-7.DOI:10.1007/s00417-014-2884-z.
6.	Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole[J]. Ophthalmology, 2013, 120(12):2611-2619.DOI:10.1016/j.ophtha.2013.07.042.
7.	Aaberg TM, Sternberg P, Glaser BM, et al. Vitrectomy for prevention of macular holes:results of a randomized multicenter clinical trial[J]. Ophthalmology, 1994, 101(6):1055-1060.
8.	Fernández MG, Navarro JC. Spontaneous closure of stage Ⅳ idiopathic full-thickness macular hole and late reopening as a lamellar macular hole:a case report[J]. J Med Case Rep, 2012, 6:169. DOI:10.1186/1752-1947-6-169.
9.	Schweitzer KD, García R. Spontaneous closure of a stage Ⅲ idiopathic macular hole[J]. Can J Ophthalmol, 2007, 42(1):127-128. DOI:10.3129/can.j.ophthalmol.06-107.
10.	Kelkar AS, Bhanushali DR, Kelkar JA, et al. Spontaneous closure of a full-thickness stage 2 idiopathic macular hole without posterior vitreous detachment[J]. Case Rep Ophthalmol, 2013, 4(3):188-191.DOI:10.1159/000356125.
11.	Freund KB, Ciardella AP, Shah V, et al. Optical coherence tomography documentation of spontaneous macular hole closure without posterior vitreous detachment[J]. Retina, 2002, 22(4):506-509. DOI:10.1097/00006982-200208000-00022.
12.	Tadayoni R, Massin P, Haouchine B, et al. Spontaneous resolution of small stage 3 and 4 full-thickness macular holes viewed by optical coherence tomography[J]. Retina, 2001, 21(2):186-189. DOI:10.1097/00006982-200104000-00019.
13.	Fujii GY, De Juan E Jr, Humayun MS, et al. A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery[J]. Ophthalmology, 2002, 109(10):1807-1813. DOI:10.1016/S0161-6420(02)01179-X.
14.	Fujii GY, De Juan E Jr, Humayun MS, et al. Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery[J]. Ophthalmology, 2002, 109(10):1814-1820. DOI:10.1016/S0161-6420(02)01119-3.
15.	Eckardt C. Transconjunctival sutureless 23-gauge vitrectomy[J]. Retina, 2005, 25(2):208-211. DOI:10.1097/00006982-200502000-00015.
16.	Kusuhara S, Ooto S, Kimura D, et al. Outcomes of 23-and 25-gauge transconjunctival sutureless vitrectomies for idiopathic macular holes[J]. Br J Ophthalmol, 2008, 92(9):1261-1264. DOI:10.1155/2013/784172.
17.	甘春兰. 内界膜剥除治疗特发性黄斑裂孔的研究进展[J]. 中华实验眼科杂志, 2016, 34(3):280-282.DOI:10.3760/cma.j.issn.2095-0160.2016.03.018. Gan CL. Advanced researches on treatment of idiopathic macular holes[J].Chin J Exp Ophthalmol, 2016, 34(3):280-282.DOI:10.3760/cma.j.issn.2095-0160.2016.03.018.
18.	Enaida H, Hisatomi T, Hata Y, et al. Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling[J]. Retina, 2006, 26(6):631-636. DOI:10.1097/00006982-200607000-00007.
19.	Schumann RG, Gandorfer A, Priglinger SG, et al. Vital dyes for macular surgery:a comparative electron microscopy study of the internal limiting membrane[J]. Retina, 2009, 29(5):669-676. DOI:10.1097/IAE.0b013e318196b1c8.
20.	Madi HA, Masri I, Steel DH. Optimal management of idiopathic macular holes[J]. Clin Ophthalmol, 2016, 10:97-116. DOI:10.2147/OPTH.S96090.
21.	Morris R, Kuhn F, Witherspoon CD. Hemorrhagic macular cysts[J]. Ophthalmology, 1994, 101(1):1.
22.	Spiteri Cornish K, Lois N, Scott NW, et al. Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole[J]. Ophthalmology, 2014, 121(3):649-655. DOI:10.1016/j.ophtha.2013.10.020.
23.	Kumagai K, Furukawa M, Ogino N, et al. Incidence and factors related to macular hole reopening[J]. Am J Ophthalmol, 2009, 149(1):127-132. DOI:10.1016/j.ajo.2009.08.002.
24.	Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes[J]. Ophthalmology, 2010, 117(10):2018-2025. DOI:10.1016/j.ophtha.2010.02.011.
25.	Shin MK, Park KH, Park SW, et al. Perfluoro-n-octane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery[J]. Retina, 2014, 34(9):1905-1910. DOI:10.1097/IAE.0000000000000339.
26.	Ho TC, Yang CM, Huang JS, et al. Erratum to:foveola nonpeeling internal limiting membrane surgery to prevent inner retinal damages in early stage 2 idiopathic macula hole[J]. Albrecht Von Graæes Archiv Für Ophthalmologie, 2014, 252(10):1553-1560. DOI:10.1007/s00417-014-2613-7.
27.	Morizane Y, Shiraga F, Kimura S, et al. Autologous transplantation of the internal limiting membrane for refractory macular holes[J]. Am J Ophthalmol, 2014, 157(4):861-869. DOI:10.1016/j.ajo.2013.12.028.
28.	Lai JC, Stinnett SS, Mccuen BW. Comparison of silicone oil versus gas tamponade in the treatment of idiopathic full-thickness macular hole[J]. Ophthalmology, 2003, 110(6):1170-1174. DOI:10.1016/S0161-6420(03)00264-1.
29.	Eckardt C, Eckert T, Eckardt U, et al. Macular hole surgery with air tamponade and optical coherence tomography-based duration of face-down positioning.[J]. Retina, 2008, 28(8):1087-1096. DOI:10.1097/IAE.0b013e318185fb5f.
30.	Guillaubey A, Malvitte L, Lafontaine PO, et al. Comparison of face-down and seated position after idiopathic macular hole surgery:a randomized clinical trial[J]. Am J Ophthalmol, 2008, 146(1):128-134. DOI:10.1016/j.ajo.2008.02.029.
31.	Lange CAK, Membrey L, Ahmad N, et al. Pilot randomised controlled trial of face-down positioning following macular hole surgery[J]. Eye, 2012, 26(2):272-277.DOI:10.1038/eye.2011.221.
32.	Solebo AL, Bunce C, Bainbridge J. Face-down positioning or posturing after macular hole surgery[J/OL]. Cochrane Database Syst Rev, 2011,12(12):CD008228[2011-12-07]. http://dx.doi.org/10.1002/14651858.CD008228.pub2.DOI:10.1002/14651858.CD008228.pub2.
33.	Kim SS, Smiddy WE, Feuer WJ, et al. Outcomes of sulfur hexafluoride (SF₆) versus perfluoropropane (C₃F₈) gas tamponade for macular hole surgery[J]. Retina, 2008, 28(10):1408-1415. DOI:10.1097/IAE.0b013e3181885009.
34.	Schurmans A, Calster JV, Stalmans P. Macular hole surgery with inner limiting membrane peeling, endodrainage, and heavy silicone oil tamponade[J]. Am J Ophthalmol, 2009, 147(3):495-500. DOI:10.1016/j.ajo.2008.09.003.
35.	Chen TC, Yang CH, Yang CM. Intravitreal expansile gas in the treatment of early macular hole:reappraisal[J]. Ophthalmologica, 2012, 228(3):159-166. DOI:10.1159/000337840.
36.	Costa RA, Cardillo JA, Morales PH, et al. Optical coherence tomography evaluation of idiopathic macular hole treatment by gas-assisted posterior vitreous detachment[J]. Am J Ophthalmol, 2001, 132(2):264-266.
37.	Wong SC, Clare G, Bunce C, et al. Cataract progression in macular hole cases:results with vitrectomy or with observation[J]. J Cataract Refract Surg, 2012, 38(7):1176-1180. DOI:10.1016/j.jcrs.2012.02.038.
38.	Gupta B, Laidlaw DAH, Williamson TH, et al. Predicting visual success in macular hole surgery[J]. Br J Ophthalmol, 2009, 93(11):1488-1491. DOI:10.1136/bjo.2008.153189.
39.	Bandello F, La SC, Iuliano L, et al. Review and perspectives on pharmacological vitreolysis[J].Ophthalmologica, 2013, 230(4):179-185. DOI:10.1159/000354547.
40.	Inoue M, Watanabe Y, Arakawa A, et al. Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes[J]. Graefe's Arch Clin Exp Ophthalmol, 2009, 247(3):325-330. DOI:10.1007/s00417-008-0999-9.
41.	Kusuhara S, Escaño MFT, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes[J]. Am J Ophthalmol, 2005, 138(5):709-716. DOI:10.1016/j.ajo.2004.04.063.
42.	Puliafito CA, Hee MR, Lin CP, et al. Imaging of macular diseases with optical coherence tomography-ophthalmology[J]. Ophthalmology, 1995, 102(2):217-229.
43.	Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery[J]. Br J Ophthalmol, 2002, 86(4):390-393.
44.	Ruizmoreno JM, Staicu C, Piñero DP, et al. Optical coherence tomography predictive factors for macular hole surgery outcome[J]. Br J Ophthalmol, 2008, 92(5):640-644. DOI:10.1136/bjo.2007.136176.

1. Gass JD. Idiopathic senile macular hole:its early stages and pathogenesis[J].Arch Ophthalmol, 2004, 23(6):629-639. DOI:10.1001/archopht.1988.01060130683026.
2. Guyer DR, Green WR. Idiopathic macular holes and precursor lesions[M]//Franklin RM. Retina and vitreous. Amsterdam:Kugler Publications, 1993:135-162.
3. Kwok AK, Li WW, Pang CP, et al. Indocyanine green staining and removal of internal limiting membrane in macular hole surgery:histology and outcome[J]. Am J Ophthalmol, 2001, 132(2):178-183.
4. Spaide RF. Macular hole hypotheses[J].Am J Ophthalmol, 2005, 139(1):149-151. DOI:10.1016/j.ajo.2004.09.027.
5. Woon WH, Greig D, Savage MD, et al. Asymmetric vitreomacular traction and symmetrical full thickness macular hole formation[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(11):1-7.DOI:10.1007/s00417-014-2884-z.
6. Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole[J]. Ophthalmology, 2013, 120(12):2611-2619.DOI:10.1016/j.ophtha.2013.07.042.
7. Aaberg TM, Sternberg P, Glaser BM, et al. Vitrectomy for prevention of macular holes:results of a randomized multicenter clinical trial[J]. Ophthalmology, 1994, 101(6):1055-1060.
8. Fernández MG, Navarro JC. Spontaneous closure of stage Ⅳ idiopathic full-thickness macular hole and late reopening as a lamellar macular hole:a case report[J]. J Med Case Rep, 2012, 6:169. DOI:10.1186/1752-1947-6-169.
9. Schweitzer KD, García R. Spontaneous closure of a stage Ⅲ idiopathic macular hole[J]. Can J Ophthalmol, 2007, 42(1):127-128. DOI:10.3129/can.j.ophthalmol.06-107.
10. Kelkar AS, Bhanushali DR, Kelkar JA, et al. Spontaneous closure of a full-thickness stage 2 idiopathic macular hole without posterior vitreous detachment[J]. Case Rep Ophthalmol, 2013, 4(3):188-191.DOI:10.1159/000356125.
11. Freund KB, Ciardella AP, Shah V, et al. Optical coherence tomography documentation of spontaneous macular hole closure without posterior vitreous detachment[J]. Retina, 2002, 22(4):506-509. DOI:10.1097/00006982-200208000-00022.
12. Tadayoni R, Massin P, Haouchine B, et al. Spontaneous resolution of small stage 3 and 4 full-thickness macular holes viewed by optical coherence tomography[J]. Retina, 2001, 21(2):186-189. DOI:10.1097/00006982-200104000-00019.
13. Fujii GY, De Juan E Jr, Humayun MS, et al. A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery[J]. Ophthalmology, 2002, 109(10):1807-1813. DOI:10.1016/S0161-6420(02)01179-X.
14. Fujii GY, De Juan E Jr, Humayun MS, et al. Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery[J]. Ophthalmology, 2002, 109(10):1814-1820. DOI:10.1016/S0161-6420(02)01119-3.
15. Eckardt C. Transconjunctival sutureless 23-gauge vitrectomy[J]. Retina, 2005, 25(2):208-211. DOI:10.1097/00006982-200502000-00015.
16. Kusuhara S, Ooto S, Kimura D, et al. Outcomes of 23-and 25-gauge transconjunctival sutureless vitrectomies for idiopathic macular holes[J]. Br J Ophthalmol, 2008, 92(9):1261-1264. DOI:10.1155/2013/784172.
17. 甘春兰. 内界膜剥除治疗特发性黄斑裂孔的研究进展[J]. 中华实验眼科杂志, 2016, 34(3):280-282.DOI:10.3760/cma.j.issn.2095-0160.2016.03.018. Gan CL. Advanced researches on treatment of idiopathic macular holes[J].Chin J Exp Ophthalmol, 2016, 34(3):280-282.DOI:10.3760/cma.j.issn.2095-0160.2016.03.018.
18. Enaida H, Hisatomi T, Hata Y, et al. Brilliant blue G selectively stains the internal limiting membrane/brilliant blue G-assisted membrane peeling[J]. Retina, 2006, 26(6):631-636. DOI:10.1097/00006982-200607000-00007.
19. Schumann RG, Gandorfer A, Priglinger SG, et al. Vital dyes for macular surgery:a comparative electron microscopy study of the internal limiting membrane[J]. Retina, 2009, 29(5):669-676. DOI:10.1097/IAE.0b013e318196b1c8.
20. Madi HA, Masri I, Steel DH. Optimal management of idiopathic macular holes[J]. Clin Ophthalmol, 2016, 10:97-116. DOI:10.2147/OPTH.S96090.
21. Morris R, Kuhn F, Witherspoon CD. Hemorrhagic macular cysts[J]. Ophthalmology, 1994, 101(1):1.
22. Spiteri Cornish K, Lois N, Scott NW, et al. Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole[J]. Ophthalmology, 2014, 121(3):649-655. DOI:10.1016/j.ophtha.2013.10.020.
23. Kumagai K, Furukawa M, Ogino N, et al. Incidence and factors related to macular hole reopening[J]. Am J Ophthalmol, 2009, 149(1):127-132. DOI:10.1016/j.ajo.2009.08.002.
24. Michalewska Z, Michalewski J, Adelman RA, et al. Inverted internal limiting membrane flap technique for large macular holes[J]. Ophthalmology, 2010, 117(10):2018-2025. DOI:10.1016/j.ophtha.2010.02.011.
25. Shin MK, Park KH, Park SW, et al. Perfluoro-n-octane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery[J]. Retina, 2014, 34(9):1905-1910. DOI:10.1097/IAE.0000000000000339.
26. Ho TC, Yang CM, Huang JS, et al. Erratum to:foveola nonpeeling internal limiting membrane surgery to prevent inner retinal damages in early stage 2 idiopathic macula hole[J]. Albrecht Von Graæes Archiv Für Ophthalmologie, 2014, 252(10):1553-1560. DOI:10.1007/s00417-014-2613-7.
27. Morizane Y, Shiraga F, Kimura S, et al. Autologous transplantation of the internal limiting membrane for refractory macular holes[J]. Am J Ophthalmol, 2014, 157(4):861-869. DOI:10.1016/j.ajo.2013.12.028.
28. Lai JC, Stinnett SS, Mccuen BW. Comparison of silicone oil versus gas tamponade in the treatment of idiopathic full-thickness macular hole[J]. Ophthalmology, 2003, 110(6):1170-1174. DOI:10.1016/S0161-6420(03)00264-1.
29. Eckardt C, Eckert T, Eckardt U, et al. Macular hole surgery with air tamponade and optical coherence tomography-based duration of face-down positioning.[J]. Retina, 2008, 28(8):1087-1096. DOI:10.1097/IAE.0b013e318185fb5f.
30. Guillaubey A, Malvitte L, Lafontaine PO, et al. Comparison of face-down and seated position after idiopathic macular hole surgery:a randomized clinical trial[J]. Am J Ophthalmol, 2008, 146(1):128-134. DOI:10.1016/j.ajo.2008.02.029.
31. Lange CAK, Membrey L, Ahmad N, et al. Pilot randomised controlled trial of face-down positioning following macular hole surgery[J]. Eye, 2012, 26(2):272-277.DOI:10.1038/eye.2011.221.
32. Solebo AL, Bunce C, Bainbridge J. Face-down positioning or posturing after macular hole surgery[J/OL]. Cochrane Database Syst Rev, 2011,12(12):CD008228[2011-12-07]. http://dx.doi.org/10.1002/14651858.CD008228.pub2.DOI:10.1002/14651858.CD008228.pub2.
33. Kim SS, Smiddy WE, Feuer WJ, et al. Outcomes of sulfur hexafluoride (SF₆) versus perfluoropropane (C₃F₈) gas tamponade for macular hole surgery[J]. Retina, 2008, 28(10):1408-1415. DOI:10.1097/IAE.0b013e3181885009.
34. Schurmans A, Calster JV, Stalmans P. Macular hole surgery with inner limiting membrane peeling, endodrainage, and heavy silicone oil tamponade[J]. Am J Ophthalmol, 2009, 147(3):495-500. DOI:10.1016/j.ajo.2008.09.003.
35. Chen TC, Yang CH, Yang CM. Intravitreal expansile gas in the treatment of early macular hole:reappraisal[J]. Ophthalmologica, 2012, 228(3):159-166. DOI:10.1159/000337840.
36. Costa RA, Cardillo JA, Morales PH, et al. Optical coherence tomography evaluation of idiopathic macular hole treatment by gas-assisted posterior vitreous detachment[J]. Am J Ophthalmol, 2001, 132(2):264-266.
37. Wong SC, Clare G, Bunce C, et al. Cataract progression in macular hole cases:results with vitrectomy or with observation[J]. J Cataract Refract Surg, 2012, 38(7):1176-1180. DOI:10.1016/j.jcrs.2012.02.038.
38. Gupta B, Laidlaw DAH, Williamson TH, et al. Predicting visual success in macular hole surgery[J]. Br J Ophthalmol, 2009, 93(11):1488-1491. DOI:10.1136/bjo.2008.153189.
39. Bandello F, La SC, Iuliano L, et al. Review and perspectives on pharmacological vitreolysis[J].Ophthalmologica, 2013, 230(4):179-185. DOI:10.1159/000354547.
40. Inoue M, Watanabe Y, Arakawa A, et al. Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes[J]. Graefe's Arch Clin Exp Ophthalmol, 2009, 247(3):325-330. DOI:10.1007/s00417-008-0999-9.
41. Kusuhara S, Escaño MFT, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes[J]. Am J Ophthalmol, 2005, 138(5):709-716. DOI:10.1016/j.ajo.2004.04.063.
42. Puliafito CA, Hee MR, Lin CP, et al. Imaging of macular diseases with optical coherence tomography-ophthalmology[J]. Ophthalmology, 1995, 102(2):217-229.
43. Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery[J]. Br J Ophthalmol, 2002, 86(4):390-393.
44. Ruizmoreno JM, Staicu C, Piñero DP, et al. Optical coherence tomography predictive factors for macular hole surgery outcome[J]. Br J Ophthalmol, 2008, 92(5):640-644. DOI:10.1136/bjo.2007.136176.

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