Macular holes

In General

Macular holes occur especially with the older population and more frequent with women.  They are caused because of some sort of traction from the liquid on the macula.  That way a central sphere-form whole develops in the cornea by which at that spot there exist no more photoreceivers.

Diagnosis

In the begin stage there is a slight decline of the sharpness of the vue together with metamorphopsie (= deformed images). In an advanced stage an important side loss occurs.
An exam of the eye fundus shows a small round or oval hole in the cornea with an oedeen collar around it. On the bottom of the hole we see sometimes small sediments of white material.
This affection can be documented with the help of angiography, but even better with the help of OCT (= Optical Coherence Tomography).

Prognosis

In an early stage, the chance exists that the small hole closes itself spontaneously, but this is no longer the case when it is about a larger hole.  The risk at bilateral occurence of the affection is 10%.

Treatment

The treatment exist of a posterier pars plana vitrectomy by which the liquid that execises a traction on the macula is removed surgically. At the end of such procedure, the eye is filled with an oil tamponnade by which the closed hole is kept closed during the healing process.

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