Vitreoretinal microsurgery is often successful in closing idiopathic macular holes.1,2 Anatomic closure of the hole has been reported in 73% to 91% of cases and the majority of anatomically successful cases will achieve 2 or more lines of improved visual acuity.
Vitreoretinal traction is a common component of both idiopathic macular hole and proliferative diabetic retinopathy. In idiopathic macular hole, tangential vitreous traction has been proposed as the primary cause of macular hole formation. In proliferative diabetic retinopathy, a partial posterior vitreous detachment may leave residual vitreoretinal traction in the posterior pole.
Two patients with proliferative diabetic retinopathy developed a full-thickness macular hole, causing marked visual loss. Both patients were treated with pars plana vitrectomy, removal of the posterior cortical vitreous layer, and use of a long-acting gas tamponade.
Report of Cases.
Flynn HW. Macular Hole Surgery in Patients With Proliferative Diabetic Retinopathy. Arch Ophthalmol. 1994;112(7):877-878. doi:10.1001/archopht.1994.01090190021011