title: THE ASSOCIATION OF EPIRETINAL MEMBRANE WITH MACULAR HOLE FORMATION AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR.
abstract: OBJECTIVE
  To describe the clinical and optical coherence tomography findings associated with the development of full-thickness macular holes after rhegmatogenous retinal detachment (RRD) repair.
  
  
  METHODS
  Retrospective, interventional case series. All patients who developed full-thickness macular holes after successful RRD repair from 3 clinical practices were reviewed. All cases of combined/simultaneous full-thickness macular hole and RRD were excluded. The main outcome measure was the presence of an epiretinal membrane at time of diagnosis of macular hole.
  
  
  RESULTS
  Twenty-five full-thickness macular holes were diagnosed after successful retinal detachment repair. Surgical approach to RRD repair included pneumatic retinopexy (6, 24%), scleral buckle alone (5, 20%), pars plana vitrectomy only (8, 32%), and combined scleral buckle and pars plana vitrectomy (6, 24%). The preceding RRD involved the macula in 19 patients (76%) before the formation of the macular hole. The median time to full-thickness macular hole diagnosis after RRD repair was 63 days (range, 4-4,080 days). An epiretinal membrane was present in all 25 (100%) macular holes. Two macular holes (8%) spontaneously closed, whereas the other 23 (92%) were successfully closed with a single surgical procedure. Mean visual acuity improved by approximately 5 lines to 20/72 (range, 20/20 to counting fingers at 1 foot) from 20/240 (range, 20/30 to hand motions) after macular hole repair (P < 0.0001).
  
  
  CONCLUSIONS
  Full-thickness macular hole formation can occur after all types of RRD repair and is associated with an epiretinal membrane. The epiretinal membrane may play a role in the pathogenesis of secondary macular hole formation after RRD repair.
authors.affiliation: *Northern California Retina Vitreous Associates, Mountain View, California; †Department of Ophthalmology, University of California, San Francisco, San Francisco, California; ‡Retina Consultants of Houston, Houston, Texas; §Blanton Eye Institute, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas; ¶Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; and **Celgene Corporation, Berkeley Heights, New Jersey.
authors.forename: Rahul N
authors.initials: RN
authors.lastname: Khurana
authors.forename: Charles C
authors.initials: CC
authors.lastname: Wykoff
authors.forename: Alok S
authors.initials: AS
authors.lastname: Bansal
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Akiyama
authors.forename: James D
authors.initials: JD
authors.lastname: Palmer
authors.forename: Eric
authors.initials: E
authors.lastname: Chen
authors.forename: Louis K
authors.initials: LK
authors.lastname: Chang
authors.forename: James C
authors.initials: JC
authors.lastname: Major
authors.forename: Chengqing
authors.initials: C
authors.lastname: Wu
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Croft
authors.forename: Tien P
authors.initials: TP
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000175:diagnosis / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014821:Vitrectomy / Q000009:adverse effects*