Management of eyes with both idiopathic macular hole and choroidal neovascularization.
OBJECTIVE
To describe the characteristics, treatment, and outcome of five eyes with both choroidal neovascularization (CNV) and macular hole.


METHODS
Medical records of five patients with both macular hole and CNV were reviewed.


RESULTS
All eyes had full-thickness macular holes. Most eyes had atypical-appearing macular holes (subretinal hemorrhage, prominent subretinal fluid, or discoloration at the hole margin) at presentation or subsequently when CNV developed. Fluorescein angiography (FA) confirmed the presence of CNV in each eye. Three eyes underwent combined macular hole repair and CNV removal, and sustained closure of these macular holes was achieved. A fourth eye underwent successful argon laser photocoagulation of extrafoveal CNV, and macular hole surgery was declined. The final eye underwent two macular hole repairs before sustained closure was achieved. Final visual acuity, ranging from 20/100 to hand motions, was limited by macular pathology and/or cataract.


CONCLUSIONS
Choroidal neovascularization can occur in association with a macular hole. In eyes with an atypical-appearing macular hole, FA should be obtained to detect CNV. Excision of the CNV can be done safely in conjunction with macular hole surgery. Final visual acuity may be limited by cumulative retinal and retinal pigment epithelium damage, especially in eyes with underlying macular disease.
Elsing
S H
SH
Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA.
Postel
E A
EA
Gill
M K
MK
Jampol
L M
LM
Jaffe
G J
GJ
D000328:Adult; D000368:Aged; D020256:Choroidal Neovascularization / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000627:therapeutic use; D005654:Fundus Oculi; D006801:Humans; D017075:Laser Coagulation; D008875:Middle Aged; D012167:Retinal Perforations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride