Ophthalmic Clinic "Jasne Blonia", Lodz, Poland.
Ophthalmologica. 2022;245(1):49-58. doi: 10.1159/000516768. Epub 2021 Apr 29.
To describe retinal morphology and vision recovery after spontaneous closure of full-thickness macular hole (FTMH).
Retrospective, observational study. From a database containing 750 FTMH, we included 23 cases. All patients had a complete ophthalmic examination. Swept-source optical coherence tomography angiography was performed.
Prior to spontaneous closure in 11 women and 12 men (mean age 67 years), the mean minimum FTMH diameter was 201 μm, and mean base FTMH diameter was 638 μm. Visual acuity improved from 0.29 Snellen to 0.47 Snellen (p = 0.001) after 6 months and showed no further improvement. Spontaneous closure of FTMH was associated with vitreous detachment in less than half of the cases. Irregularities in the deep vascular layer and hyporeflective areas in the choriocapillaris were noted.
Equal sex distribution of spontaneous closures (1:1) differs from the high prevalence of females seen in the literature. Complete visual recovery is uncommon in cases of spontaneous closure of FTMH. It might be explained by prolonged defects of the choriocapillaris layer. These findings, along with the evolution of the various morphologies reported in the study, could possibly suggest that delaying vitrectomy while hoping for spontaneous closure might not be justified.
描述全层黄斑裂孔（FTMH）自发闭合后的视网膜形态和视力恢复情况。
回顾性观察性研究。从一个包含 750 例 FTMH 的数据库中，我们纳入了 23 例病例。所有患者均接受了全面的眼科检查。进行了扫频源光相干断层扫描血管造影。
在 11 名女性和 12 名男性（平均年龄 67 岁）自发闭合前，平均最小 FTMH 直径为 201μm，平均基础 FTMH 直径为 638μm。视力在 6 个月后从 0.29 视力表提高到 0.47 视力表（p=0.001），之后没有进一步提高。FTMH 的自发闭合与不到一半病例中的玻璃体脱离有关。在深层血管层和脉络膜毛细血管的低反射区出现不规则。
自发闭合的性别分布（1:1）与文献中女性高发的情况不同。FTMH 自发闭合的病例中，完全视力恢复并不常见。这可能是由于脉络膜毛细血管层的缺陷持续存在所致。这些发现以及研究中报告的各种形态的演变，可能表明在希望自发性闭合的同时延迟玻璃体切割可能是不合理的。
