Characteristics, Outcomes, and Optical Coherence Tomography Features of Macular Hole After Rhegmatogenous Retinal Detachment Repair

Abstract

Purpose: To investigate full-thickness macular holes (FTMH) that develop after rhegmatogenous retinal detachment (RRD) repair. Methods: Retrospective consecutive case series of patients who underwent RRD repair between 2015 and 2021 and subsequently developed FTMH. 23 patients (23 eyes) were included. All eyes underwent PPV + MP for MH repair. Results: The mean age at RRD diagnosis was 62 years and 52% were male. 78% were macula-off RRDs. 14 (60.9%) underwent PPV alone, 7 (30.4%) underwent PPV and scleral buckling (SB), 1 (4.3%) underwent SB only, and 1 (4.3%) underwent pneumatic retinopexy. Median time from RRD repair to MH diagnosis was 116 days. Macula-off RRDs had a significantly lower time to MH diagnosis (mean 154 days, p<0.05) than macula-on RRDs (mean 875 days). 21 MH (91%) had OCT evidence of an epiretinal membrane (ERM). Mean logMAR visual acuity (VA) at MH diagnosis was 1.05 (∼20/224) and significantly improved to 0.66 (∼20/91) at final follow-up (p<0.001). 100% of MHs closed by final follow-up. Conclusions: PPV for MH after RRD repair has a high closure rate and leads to significant VA improvement. MH formation after RRD repair may be associated with macula-off detachments and ERM. Macula-off RRDs develop MH faster than macula-on RRDs.