Toumi Elsa, Guindolet Damien, Bonnin Sophie, Bruneau Sébastien, Leflot Marie, Duvillier Amélie, Lejoyeux Raphaël, Tadayoni Ramin
Ophthalmology Department, Rothschild Foundation Hospital, Paris, France.
Ophthalmology Department, University Hospital of Nice, Nice, France.
Ophthalmologica. 2025;248(1):22-28. doi: 10.1159/000541057. Epub 2024 Nov 27.
Small full-thickness macular holes (FTMHs) are classically treated surgically but can also occasionally close spontaneously. Long-term visual outcomes of spontaneously closed FTMHs are not well described. We compared best-corrected visual acuity (BCVA) after surgical and spontaneous closure of idiopathic FTMH (IMHs) and assessed the effect of IMH size on BCVA.
This retrospective study was performed at Rothschild Foundation Hospital, Paris, France, from January 2015 to June 2021. The study included patients with small IMH, i.e., ≤250 μm, divided into spontaneously closed IMH (SIMH) and surgically closed IMH. Both groups were divided into 3 subgroups according to IMH diameter: <100 μm, 100-150 μm, or 151-200 μm.
A total of 109 patients had surgical IMH closure and 18 spontaneous IMH closure. Among all the patients of the study, we observed 17% of spontaneous closure. All SIMHs were <250 μm. The groups did not differ in final BCVA or BCVA gain. BCVA significantly improved after surgery whatever the IMH size. In the SIMH group, final BCVA did not differ by IMH size. In the 100-150 μm subgroups, BCVA gain was significantly greater for the surgical closure compared to the SIMH groups (-0.35 ± 0.2 vs. -0.16 ± 0.2 logMAR; p = 0.01).
Vision results are similar between spontaneously closed and surgically closed macular holes. Spontaneous closure of macular holes can occur; it is therefore reasonable to consider observation before macular hole surgery.
小的全层黄斑裂孔（FTMHs）传统上采用手术治疗，但偶尔也会自发闭合。自发闭合的FTMHs的长期视力结果尚无详细描述。我们比较了特发性FTMH（IMHs）手术闭合和自发闭合后的最佳矫正视力（BCVA），并评估了IMH大小对BCVA的影响。
本回顾性研究于2015年1月至2021年6月在法国巴黎的罗斯柴尔德基金会医院进行。该研究纳入了小IMH患者，即≤250μm，分为自发闭合的IMH（SIMH）和手术闭合的IMH。两组根据IMH直径分为3个亚组：<100μm、100 - 150μm或151 - 200μm。
共有109例患者接受了IMH手术闭合，18例自发闭合。在该研究的所有患者中，我们观察到17%的自发闭合率。所有SIMH均<250μm。两组在最终BCVA或BCVA提高方面无差异。无论IMH大小，手术后BCVA均显著改善。在SIMH组中，最终BCVA不因IMH大小而异。在100 - 150μm亚组中，与SIMH组相比，手术闭合组的BCVA提高显著更大（-0.35±0.2对-0.16±0.2 logMAR；p = 0.01）。
自发闭合和手术闭合的黄斑裂孔的视力结果相似。黄斑裂孔可发生自发闭合；因此，在黄斑裂孔手术前考虑观察是合理的。
