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September 1992

Observations on Patients With Idiopathic Macular Holes and Cysts

Author Affiliations

From the Retinal Vascular Center and the Vitreoretinal Service, The Wilmer Ophthalmological Institute, The Johns Hopkins Medical Institutions, Baltimore, Md. Dr Guyer is now with the Retina Service, Massachusetts Eye and Ear Infirmary, Boston, Mass. Dr de Bustros is now with the Irwin Retina Center, Ingalls Memorial Hospital, Harvey, Ill. Dr Diener-West is now with The Johns Hopkins School of Hygiene and Public Health, Baltimore, Md. Dr Fine is now with the Scheie Eye Institute, University of Pennsylvania, Philadelphia.

Arch Ophthalmol. 1992;110(9):1264-1268. doi:10.1001/archopht.1992.01080210082030

• We reexamined 96 patients with macular holes or cysts. The mean follow-up period was 4.7 years. Of 19 eyes with macular cysts, only two (10.5%) showed progression to a macular hole. In 15 (79%) of those 19 eyes, the cyst disappeared. Of 80 patients with a macular hole or cyst in one eye and a normal fellow eye, a hole developed in the fellow eye in only one patient (1.2%) and a cyst developed in the fellow eye in only two patients (2.5%). Of 66 eyes with a stage 3 full-thickness macular hole, three eyes (5%) showed resolution without any sign of a hole. Our results suggest a favorable prognosis for normal fellow eyes of patients with macular holes or cysts and for eyes with cysts. Eyes with full-thickness macular holes have a less favorable prognosis, although their natural history may not be as poor as previously thought.