title: Macular hole in Behçet's disease.
abstract: OBJECTIVE
  To investigate the clinical features, prevalence, role of surgical intervention and the visual prognosis of macular holes (MH) in patients with Behcet's disease (BD).
  
  
  METHODS
  Retrospective study of patients with BD and MH from January 1998 to November 2008.
  
  
  RESULTS
  Out of 159 patients, 21 eyes of 17 patients were identified with MH. The mean age was 38.59 (range 23-61) years and the mean follow-up period was 5.1 years (range 13-164 months). The prevalence of MH was 7%. Visual acuity (VA) at the time of presentation ranged from 20/70 to hand-motion. Optical coherence tomography (OCT) findings revealed intraretinal cysts at the edge of the MH. The mean size of MH was 983.6 um; 52% had elevated edges, 43% had flat edges and only one eye (5%) was closed postoperatively. Fluorescein angiography (FA) was consistent with macular ischemia in 76% of the cases. Human leukocyte antigen (HLA) B51 association was found in 14 of the 15 patients investigated. Six patients (out of 17) underwent pars plana vitrectomy. The final VA on their last follow-up ranged from 20/70 to 2/200. Surgical intervention for MH did not result in any visual improvement as compared to non-operated eyes. One patient lost vision completely due to elevated intraocular pressure post vitrectomy and silicon oil tamponade.
  
  
  CONCLUSIONS
  MH in patients with BD may lead to significant visual disability. Surgical intervention does not seem to have any potential beneficial effect on the VA, probably due to significant macular ischemia and sequelae from the ocular inflammation.
authors.affiliation: Uveitis Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia. hdhibi@yahoo.com
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Dhibi
authors.forename: Marwan
authors.initials: M
authors.lastname: Abouammoh
authors.forename: Essam
authors.initials: E
authors.lastname: Al-Harthi
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Gaeed
authors.forename: Jorgen
authors.initials: J
authors.lastname: Larsson
authors.forename: Emad
authors.initials: E
authors.lastname: Abboud
authors.forename: Imtiaz
authors.initials: I
authors.lastname: Chaudhry
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology* / Q000503:physiopathology; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods; D055815:Young Adult