title: Risk of decreased visual acuity in full-thickness idiopathic macular holes.
abstract: We studied 169 eyes of 149 patients with a full-thickness idiopathic macular hole to ascertain the risk factors of enlargement of the hole or the surrounding retinal detachment and subsequent decreased visual acuity. Eyes were divided as follows: group A, 48 eyes with no posterior vitreous detachment and a hole 400 microns or smaller; group B, 77 eyes with no posterior vitreous detachment and a hole 400 microns or larger; group C, 13 eyes with posterior vitreous detachment and a hole 400 microns or smaller; group D, 31 eyes with posterior vitreous detachment and a hole 400 microns or larger. In group A, the macular hole enlarged in 37 eyes (77%); the retinal detachment enlarged in 35 eyes (73%); and visual acuity decreased by two or more Snellen lines in 28 eyes (58%). These percentages were significantly higher than those in group B (P = .01, P = .01, and P = .01, respectively), group C (P = .02, P = .01, and P = .01, respectively), and group D (P = .01, P = .05, and P = .01, respectively). Eyes without posterior vitreous detachment with a full-thickness idiopathic macular hole 400 microns or smaller may have a greater risk of an enlarged macular hole, surrounding retinal detachment, and subsequent visual loss.
authors.affiliation: Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114.
authors.forename: T
authors.initials: T
authors.lastname: Hikichi
authors.forename: C L
authors.initials: CL
authors.lastname: Trempe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D012163:Retinal Detachment / Q000150:complications / Q000473:pathology; D012167:Retinal Perforations / Q000150:complications* / Q000473:pathology; D012307:Risk Factors; D014786:Vision Disorders / Q000209:etiology*; D014792:Visual Acuity