title: Proliferative vitreoretinopathy may be a risk factor in combined macular hole retinal detachment cases.
abstract: OBJECTIVE
  To review the incidence and closure rate of full-thickness macular holes (MH) in cases associated with concomitant rhegmatogenous retinal detachment (RRD).
  
  
  METHODS
  A retrospective consecutive case series was performed from patients undergoing surgical repair of RRD and simultaneous closure of MH. The presence of proliferative vitreoretinopathy (PVR), rates of hole closure and reattachment, and visual acuity outcomes were evaluated.
  
  
  RESULTS
  There were a total of 607 RRDs during the study period. The incidence of concomitant MH in RRD cases was 2.3% (14 of 607), and the overall incidence of PVR was 15.8% (96 of 607). All eyes with a MH had a primary break that was distinct from the MH. Five patients did not meet the inclusion criteria for review of the postoperative outcomes. In the remaining 9 patients, the retinal reattachment rate was 100%, and MH closure was achieved in 8 of 9 (89%) eyes after a single surgery. At the time of primary repair, PVR was present in 6 of these 9 cases (66.7%). There was a significant association between the presence of PVR and a concomitant MH (P = 0.0027). The mean preoperative visual acuity was 2.59 ± 0.649 logarithm of the minimum angle of resolution units and significantly improved to 1.23 ± 1.01 logarithm of the minimum angle of resolution units (P = 0.00124). Overall, 88.8% of patients showed an improvement in visual acuity at the final postoperative visit, and a visual acuity of 20/125 or better was achieved in 66.7% of cases.
  
  
  CONCLUSIONS
  Macular holes combined with a RRD are infrequent, and good anatomical results can be achieved after a simultaneous repair. Also, PVR may be more frequently encountered in this particular subset of RRDs.
authors.affiliation: Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Cunningham
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Tarantola
authors.forename: James C
authors.initials: JC
authors.lastname: Folk
authors.forename: Elliott H
authors.initials: EH
authors.lastname: Sohn
authors.forename: H Culver
authors.initials: HC
authors.lastname: Boldt
authors.forename: Jordan A
authors.initials: JA
authors.lastname: Graff
authors.forename: Korianne
authors.initials: K
authors.lastname: Elkins
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Russell
authors.forename: Vinit B
authors.initials: VB
authors.lastname: Mahajan
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D012167:Retinal Perforations / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012591:Scleral Buckling; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000150:complications*