Macular hole in proliferative diabetic retinopathy with fibrovascular proliferation

Abstract

Purpose: To report clinical characteristics and treatment results of macular hole (MH) with diabetic fibrovascular proliferation.

Methods: Twenty-three eyes of 23 consecutive patients having surgery for diabetic fibrovascular proliferation and MH were reviewed. Macular hole closure and final visual acuity were examined in relation to clinical characteristics.

Results: Traction and combined retinal detachment was seen in 17 cases and 6 cases, respectively. Four cases had internal limiting membrane (ILM) peeling. Macular hole was closed in 19 cases (82.6%) after surgery. Thickened fibrovascular proliferation with vitreomacular adhesion at or close to the MH edge was found in most cases. Of the 5 cases of shallow macular detachment, 2 cases without ILM peeling had persistent hole; 3 cases with ILM peeling had MH closure. Of the other 18 cases, only 2 of the 17 cases without ILM peeling had persistent hole (P = 0.64). Multiple regression analysis revealed preoperation visual acuity and degree of macular elevation were associated with postoperation visual acuity.

Conclusions: Unique vitreomacular features exist in diabetic fibrovascular proliferation and MH. Internal limiting membrane peeling does not seem to significantly affect MH closure in cases with moderate or high macular detachment. Final vision may be associated with preoperative visual acuity and degree of macular elevation.