Hikichi T, Yoshida A, Akiba J, Trempe C L
Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Br J Ophthalmol. 1995 Jun;79(6):517-20. doi: 10.1136/bjo.79.6.517.
A study was carried out to ascertain the natural outcome of each stage of idiopathic macular hole.
One hundred and fifty four eyes with different stages of idiopathic macular holes were retrospectively studied: stage 1 (40 eyes), 2 (25 eyes), 3 (58 eyes), and 4 (31 eyes).
Of 27 of 40 eyes with a stage 1 lesion with posterior vitreous attachment to the macula initially, nine (33%) eyes developed a full thickness macular hole. No stage 1 lesions with posterior vitreous separation from the macula initially progressed to full thickness holes. Twenty one (84%) of 25 eyes with a stage 2 lesion, 32 (55%) of 58 eyes with a stage 3 lesion, and five (16%) of 31 eyes with a stage 4 lesion underwent macular hole enlargement during the median follow up period of 3 years. Visual acuity decreased two or more lines of Snellen equivalent during the follow up period in 12 (30%) eyes with a stage 1 lesion, 17 (68%) eyes with a stage 2 lesion, 17 (29%) eyes with a stage 3 lesion, and four (13%) eyes with a stage 4 lesion. The percentage was significantly higher in eyes with stage 2 lesions than the other stages (p < 0.01).
The results suggest that the different stages of idiopathic macular holes have different natural outcomes, and the management depends on the stage at presentation.
开展一项研究以确定特发性黄斑裂孔各阶段的自然转归。
对154只患有不同阶段特发性黄斑裂孔的眼睛进行回顾性研究：1期（40只眼）、2期（25只眼）、3期（58只眼）和4期（31只眼）。
最初黄斑部有玻璃体后皮质附着的40只1期病变眼中，27只眼有9只（33%）发展为全层黄斑裂孔。最初黄斑部有玻璃体后脱离的1期病变眼均未进展为全层裂孔。在3年的中位随访期内，25只2期病变眼中有21只（84%）、58只3期病变眼中有32只（55%）、31只4期病变眼中有5只（16%）黄斑裂孔扩大。随访期间，12只（30%）1期病变眼、17只（68%）2期病变眼、17只（29%）3期病变眼和4只（13%）4期病变眼的视力下降了两行或更多Snellen等效视力。2期病变眼的这一比例显著高于其他阶段（p<0.01）。
结果表明，特发性黄斑裂孔的不同阶段有不同的自然转归，治疗方法取决于就诊时的阶段。
