Cavallerano A A, Woodcome H T
J Am Optom Assoc. 1994 Dec;65(12):845-54.
A full-thickness macular hole is a retinal opening involving the fovea causing severe central vision loss among the elderly.
This paper examines the pathogenesis and mechanistic constructs for the development and formation of idiopathic macular hole, reviews the stages of evolution, and provides guidelines for management by the primary care clinician. An update of the current methods of diagnosis and the criteria for surgical intervention, including vitrectomy and epiretinal membrane removal are presented. A perspective on the emerging trends in the treatment of macular hole using transforming growth factor beta-2 application is also introduced.
Clinical practice guidelines for the management of patients with macular holes can be established based on an improved understanding of the pathogenesis of macular hole formation, a knowledge of the various stages of evolution, and the primary care clinician's familiarity with improved diagnostic techniques. An enhanced understanding of the pathogenesis of macular hole will help to predict the risk for the fellow eye, will promote more effective patient education and counseling, and will result in more timely surgical intervention.
More promising results in the surgical closure of macula holes can prevent or minimize significant central vision loss.
全层黄斑裂孔是一种累及黄斑中心凹的视网膜裂孔，可导致老年人严重的中心视力丧失。
本文探讨特发性黄斑裂孔发生发展的发病机制和机制构建，回顾其演变阶段，并为基层医疗临床医生提供管理指南。介绍了当前诊断方法以及手术干预标准（包括玻璃体切除术和视网膜前膜切除术）的更新情况。还介绍了使用转化生长因子β-2治疗黄斑裂孔的新兴趋势。
基于对黄斑裂孔形成发病机制的深入理解、对各个演变阶段的认识以及基层医疗临床医生对改进诊断技术的熟悉程度，可以制定黄斑裂孔患者管理的临床实践指南。对黄斑裂孔发病机制的深入理解将有助于预测对侧眼的风险，促进更有效的患者教育和咨询，并实现更及时的手术干预。
黄斑裂孔手术封闭取得更有前景的结果可预防或最大程度减少严重的中心视力丧失。
