What is a macular hole?
A macular hole is a tear by traction of the center of the retina (macula).
There are two types of macular hole, depending on whether they partially or totally affect the thickness of the retina. On the one hand, there are those holes that affect the entire retina, the so-called lamellar macular holes. On the other hand, there are macular holes that partially affect the retina, known as post-traumatic macular holes. There are also different grades:
- Grade 1: detachment of the foveal area of the retina.
- Grade 2: complete retinal hole in the foveal zone.
- Grade 3: the hole increases in size
- Grade 4: the macular hole is associated with a posterior vitreous detachment.
Prognosis of the disease
The prognosis is very positive, as currently more than 90% of the cases are solved. Treatment is by vitrectomy but there are cases, in the initial stage, that can be treated by intravitreal injection. In other cases it may also heal spontaneously.
A macular hole is a traction tear in the center of the retina.
Symptoms of macular hole
The main symptoms of macular hole are loss of central vision and distortion of images in one eye. The distortion consists of a waviness of straight lines, so that numbers or letters may jump out of line.
Other symptoms reported by patients are a central gray spot or a blind spot in the central vision.
In early stages of the disease, a yellowish lesion is detected in the fovea, which is the area of the retina in the center of the macula.
Medical tests for macular hole
A fundus examination is performed to diagnose the pathology. The specialist dilates the pupils and examines the retina.
The optical coherence tomography (OCT) test determines the extent of the hole, which allows to see the prognosis and also confirms the closure of the hole postoperatively.
What are the causes of macular hole?
The main cause of a macular hole is diopathic. That is, the macular hole appears in healthy patients without any evidence of other ocular disease. It is age-related.
There are other secondary causes such as:
- Myopia
- Ocular trauma
- Chronic inflammation of the macula
- Intraocular surgery
Can it be prevented?
It is not a disease that can be prevented, but it can be detected in its early stages. Visual recovery is always better the sooner the hole is detected and, therefore, the sooner it will close.
Treatments for macular hole
The treatment of macular hole is always surgical. The specialist performs a vitrectomy, removing the innermost layer of the retina, called the internal limiting membrane.
The macula is responsible for providing central vision and allows us to capture details in order to be able to perform everyday actions, such as reading.
What specialist treats it?
The macular hole is treated by a specialist in Ophthalmology.