Size and vitreomacular attachment of primary full-thickness macular holes

Purpose

To study the relationship between the size of primary full-thickness macular hole (MH) and the vitreomacular attachment status.

Design

Single-centre retrospective observational case series.

Methods

The records of 100 consecutive eyes operated for primary full-thickness MH were retrospectively reviewed. The vitreous status and MH diameter were assessed on the preoperative optical coherence tomography scans. MH were classified depending on the presence or absence of vitreomacular traction (VMT) and their size as small (<250 µm), medium (250–400 µm) and large (>400 µm), as suggested in the International VMT Study Group Classification.

Results

22% of MH had VMT and 13% had both VMT and a diameter <400 µm. The MH diameter was not significantly different depending on the presence or absence of VMT (respectively, 339±134 and 423±191 µm (p=0.094)), with large overlap between groups. Small, medium and large MH were similarly distributed regardless of the presence or absence of VMT (p=0.69).

Conclusions

Our series of 100 MH did not reveal any significant relationship between the MH size and the presence or absence of VMT. Only 13% of MH had VMT and a diameter <400 mm, then were eligible for intravitreal ocriplasmin as a possible treatment.

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