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Purpose: This study aims to describe and analyze the clinical characteristics of atrophic macular hole (AMH), a severe complication in patients with pathologic myopia (PM).
Methods: A multicenter, retrospective analysis was conducted involving 17 patients (17 eyes) diagnosed with AMH and 52 patients (52 eyes) diagnosed with simple macular hole (SMH) in PM from January 2023 to December 2023. Clinical data and multimodal images were collected. The age, gender, spherical equivalent (SE), axial length (AL), and best-corrected visual acuity (BCVA) of patients with AMH were described and their imaging characteristics analyzed.
Results: Of the 17 patients diagnosed with AMH, 15 (88.24 %) were female; the mean age was 64.59±12.61 years; the SE was -17.85±4.15 D; the AL was 30.40±1.67 mm; and the BCVA was 1.30 (1.00, 1.35) logMAR. Eleven eyes (64.71 %) exhibited myopic foveoschisis, seven eyes showed choroidal neovascularization (Fuchs spot), one eye had a concomitant epiretinal membrane, and no cases of retinal detachment involving the macula were observed. Axial length and neovascularization were significant correlates of BCVA in AMH patients (P < 0.05). Compared with SMH in PM, patients with AMH were older (t = 2.247, P = 0.028) and had worse BCVA (Z = 375, P = 0.037); no significant differences were found between the two groups in terms of gender, SE, and AL (P > 0.05).
Conclusion: We propose the term "atrophic macular hole" to describe a condition resembling a macular hole accompanied by atrophy of the RPE and choroid, caused by progressive degeneration of the outer retina or traction of the eyeball, which severely impairs central vision in patients.
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http://dx.doi.org/10.1016/j.pdpdt.2025.104680 | DOI Listing |
Retina
September 2025
Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010.
Purpose: To evaluate inter-grader variability in posterior vitreous detachment (PVD) classification in patients with epiretinal membrane (ERM) and macular hole (MH) on spectral-domain optical coherence tomography (SD-OCT) and identify challenges in defining a reliable ground truth for artificial intelligence (AI)-based tools.
Methods: A total of 437 horizontal SD-OCT B-scans were retrospectively selected and independently annotated by six experienced ophthalmologists adopting four categories: 'full PVD', 'partial PVD', 'no PVD', and 'ungradable'. Inter-grader agreement was assessed using pairwise Cohen's kappa scores.
Retina
September 2025
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Purpose: To evaluate the long-term functional and anatomical outcomes in patients with tractional lamellar macular holes who were managed without surgical intervention.
Methods: 63 eyes previously diagnosed with tractional lamellar macular hole between July 1, 2009 and January 30, 2024 without any surgical interventions were enrolled. The change in best-corrected visual acuity (BCVA), lamellar hole diameter, central retinal thickness (CRT) on Optical coherence tomography (OCT), foveal avascular zone (FAZ) areas on OCT angiography, and M-chart scores between initial and final visit were assessed.
Br J Ophthalmol
September 2025
Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Background: Persistent full-thickness macular holes (FTMHs) following primary surgery represent a therapeutic challenge. Various surgical treatment approaches have been proposed. This study evaluates anatomical and functional outcomes of a temporary silicone oil tamponade in persistent FTMH in a larger cohort.
View Article and Find Full Text PDFThe introduction of autologous neurosensory retinal transplantation (ANRT) into vitreoretinal surgery has significantly improved the success rates of closure of refractory full-thickness macular holes (FTMH). In recent years, the technique has gained wide acceptance and its indications have expanded; however, certain aspects remain debatable - particularly the optimal graft size to ensure the best anatomical and functional outcomes. To address this issue, the study proposes a surgical technique for treating FTMH using ANRT that involves precise marking of the neurosensory retinal graft.
View Article and Find Full Text PDFAm J Ophthalmol Case Rep
September 2025
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
Purpose: To report two cases of macular exudations resulting from retinal arterial macroaneurysms (MaAs) refractory to focal photocoagulations that were treated with a new surgical technique including subretinal balanced saline solution (BSS) injection to dilute lipid-rich subretinal fluid (SRF) and facilitate absorption of the SRF, intentional retinal hole formation to direct SRF into the vitreous cavity, and laser photocoagulation posterior to the MaAs to prevent intraretinal fluid and SRF from reaching the fovea.
Observations: A 70-year-old man with macular edema (ME) refractory to anti-vascular endothelial growth factor (VEGF) therapy was referred to our hospital. Fundus examination showed retinal arterial MaAs and hard exudations.