The association of epiretinal membrane with macular hole formation after rhegmatogenous retinal detachment repair

Rahul N. Khurana, Charles C. Wykoff, Alok S. Bansal, Kunihiko Akiyama, James D. Palmer, Eric Chen, Louis K. Chang, James C. Major, Chengqing Wu, Rui Wang, Daniel E. Croft, Tien P. Wong

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Purpose: 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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)1073-1078
Number of pages6
JournalRetina
Volume37
Issue number6
DOIs
StatePublished - Jun 1 2017

Keywords

  • epiretinal membrane
  • macular hole
  • rhegmatogenous retinal detachment

ASJC Scopus subject areas

  • Ophthalmology

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