Garg Anubhav, Ballios Brian G, Yan Peng
Faculty of Medicine, University of Toronto, Toronto, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
J Vitreoretin Dis. 2021 Oct 24;6(5):381-390. doi: 10.1177/24741264211049873. eCollection 2022 Sep-Oct.
This work reviews the literature regarding spontaneous closure of idiopathic full-thickness macular holes (FTMHs).
Literature on patients with spontaneous idiopathic FTMH closure was reviewed via Ovid MEDLINE, EMBASE, and PubMed through July 16, 2020. A total of 27 of 66 identified articles were included.
A total of 68 eyes had spontaneous closure. Of the patients, 62.7% were women and the average age was 67.5 years. Visual acuity improved from Snellen 20/78 to 20/33 post closure. The average hole diameter was 176.8 μm; the largest was 350 μm. Most were stage 2 according to Gass and of small size according to International Vitreomacular Traction Study Group (IVTS) staging. The predominant classification system in recent literature is IVTS staging. The average optical coherence tomography-observed closure time was 4.5 months.
On review, reported spontaneous closure rates of all idiopathic FTMH range from 3% to 15%, and no demographic subgroups are more likely to have closure. Holes ≤250 µm have higher closure rates (22.2%) than those in the range of >250 to 400 µm (13.3%) and ≥400 µm (0%). Closure is associated with favorable visual outcomes, and retinal bridging via glial cells is likely critical to closure. These determinations were based on limited numbers; prospective studies are needed to further ascertain rate, mechanism, and characteristics. IVTS staging provides reliable reporting and insight into whether FTMH can be observed before surgery.
本研究回顾了关于特发性全层黄斑裂孔（FTMH）自发闭合的文献。
通过Ovid MEDLINE、EMBASE和PubMed检索截至2020年7月16日有关特发性FTMH自发闭合患者的文献。共纳入66篇已识别文章中的27篇。
共有68只眼自发闭合。患者中62.7%为女性，平均年龄为67.5岁。闭合后视力从Snellen 20/78提高到20/33。平均裂孔直径为176.8μm；最大为350μm。根据Gass分期，大多数为2期，根据国际玻璃体黄斑牵引研究组（IVTS）分期为小尺寸。近期文献中主要的分类系统是IVTS分期。光学相干断层扫描观察到的平均闭合时间为4.5个月。
经回顾，所有特发性FTMH的报告自发闭合率为3%至15%，且没有人口统计学亚组更易发生闭合。≤250μm的裂孔闭合率（22.2%）高于>250至400μm范围（13.3%）和≥400μm（0%）的裂孔。闭合与良好的视力结果相关，通过神经胶质细胞形成的视网膜桥接可能对闭合至关重要。这些结论基于有限的数据；需要进行前瞻性研究以进一步确定发生率、机制和特征。IVTS分期为术前是否可观察到FTMH提供了可靠的报告和见解。
