Prognosis of stage 2 macular holes.
OBJECTIVE
We ascertained the natural course of stage 2 idiopathic macular holes to determine better treatment possibilities.


METHODS
We reviewed 48 eyes with stage 2 idiopathic macular holes and followed them up for more than two years. At each examination, best-corrected Snellen visual acuity was measured by a physician masked to the hypothesis of the study.


RESULTS
Stage 2 lesions progressed to stage 3 or 4 during the follow-up period in 32 (67%) and 14 (29%) of 48 eyes, respectively; two eyes (4%) remained in stage 2. In 41 (85%) of 48 eyes, the hole size enlarged during the follow-up: 32 (94%) of 34 eyes had vitreomacular attachment and nine (64%) of 14 eyes had vitreomacular separation at the final examination, for a statistically significant difference in prevalence (P = .03). Visual acuity decreased two or more Snellen lines during the follow-up period in 34 (71%) of 48 eyes, the prevalence of which was significantly higher in eyes with vitreomacular attachment at the final examination (28 of 34, 82%) than in eyes with vitreomacular separation at the final examination (six of 14, 43%) (P = .01).


CONCLUSIONS
Even though vitreomacular separation may improve the prognosis of a macular hole, stage 2 lesions usually will develop an enlarged hole and decreased visual acuity.
Hikichi
T
T
Schepens Eye Research Institute, Boston, MA 02114, USA.
Yoshida
A
A
Akiba
J
J
Konno
S
S
Trempe
C L
CL
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012167:Retinal Perforations / Q000145:classification / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D014792:Visual Acuity