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Definition
Symptoms
- Metamorphopsias, central scotoma, reduced visual acuity
Examination
- OCT
- Fundoscopy, (Watzke-Allen-Sign)
Classification
- The International Vitreomacular Traction Study Group (2013): OCT-based classification system
- Gass (1988/1995): biomicroscopic, stages 0-4
Therapy
- depending on stage and onset of macular hole
- usually no surgery in partial-thickness macular holes, VMA and VMT
- Indication for surgery in stages 3 + 4 (Gass), consider surgery in stage 2 (spontaneous closure possible )
- Pars plana vitrectomy with ILM-peeling + tamponade
- postoperative face-down positioning (duration controversial)
Sources
- EyeWiki Macular Hole
- The International Vitreomacular Traction Study Group Classification of Vitreomacular Adhesion, Traction, and Macular Hole. Ophthalmology. 2013.
- The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
- Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)