title: Prevalence of asymptomatic macular holes in highly myopic eyes.
abstract: OBJECTIVE
  To evaluate the presence of macular holes (MHs) in very highly myopic eyes in the absence of visual symptoms.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Three hundred eighty-three eyes from 383 patients (mean age, 51.70+/-12.73 years) affected by very high myopia (between -14 and -32 diopters [D]), with no visual disturbance such as metamorphopsia and with visual acuity (VA) of >0.2 logarithm of the minimum angle of resolution, were considered in the study. They were evaluated at baseline and every 6 months during a mean total period of 30.2+/-0.5 months (range, 28.3-32.1).
  
  
  METHODS
  Evaluation of macular morphology by optical coherence tomography (OCT).
  
  
  METHODS
  Changes in OCT macular morphology ascribed to the presence of an MH.
  
  
  RESULTS
  Macular holes were detected by OCT in 24 of 383 (6.26%) myopic eyes. These MHs were defined as asymptomatic (AMHs). The presence of AMHs was more prevalent (although not significantly when compared with the overall study population) in myopic patients younger than 50 years and with concomitant myopia of >-20 D. Posterior vitreous schisis was the most frequent vitreous modification associated with AMH (18/24 eyes [75.0%]). During follow-up, a decrease in VA was observed in 5 of 24 (20.8%) AMH eyes due to the enlargement of the lesion or to posterior retinal detachment, leading to the development of a symptomatic MH. Greater degree of myopia and younger age were associated with the evolution of the macular disease, consisting of an enlargement of the MH and/or the onset of a macular detachment.
  
  
  CONCLUSIONS
  A small percentage (6.26%) of highly myopic eyes may develop an MH in the absence of visual symptoms. The absence of symptoms could be related to the localization of the hole in a juxtafoveal area. Its evolution in a symptomatic MH seems to be related to the presence of epiretinal tissue, younger age, and the degree of myopia.
authors.affiliation: Fondazione G. B. Bietti per l'Oftalmologia (I.R.C.C.S.), Rome, Italy.
authors.forename: Andrea Maria
authors.initials: AM
authors.lastname: Coppé
authors.forename: Guido
authors.initials: G
authors.lastname: Ripandelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Parisi
authors.forename: Monica
authors.initials: M
authors.lastname: Varano
authors.forename: Mario
authors.initials: M
authors.lastname: Stirpe
mesh_terms: D000328:Adult; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D015995:Prevalence; D012167:Retinal Perforations / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity