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Macular hole

A macular hole is an important eye disease that involves the macula, the most central part of the retina. Frequently, this condition occurs when the vitreous body exerts a traction force on the retinal tissue, with such intensity and duration as to cause a break in the center of the retina, with the formation of a real opening (hole).

What are the symptoms?

The macula is responsible for central vision, i.e. the fine and detailed vision that allows to read, recognize faces, watch TV, drive a car, etc. In the presence of traction on the macula, the patient can experience symptoms such as:

  • Blurred central vision;
  • Distorted central vision;
  • Perception of a blind spot in the center of vision (central scotoma).

What are the risks?

In the case of a macular hole, the lack of a prompt intervention will cause irreversible loss of central vision and, in some cases, retinal detachment.

Risk factors

There are several conditions that can lead to a macular hole:

  • Vitreomacular traction (VMT);
  • Myopia magna;
  • Proliferative diabetic retinopathy (PDR);
  • Diabetic macular edema;
  • Post-operative macular edema;
  • Persistent intraocular inflammation.

How it is diagnosed?

A macular hole can be diagnosed using tests such as:

  • Ophthalmoscopy;
  • Slit lamp;
  • The Watzke-Allen test;
  • High resolution optical coherence tomography (HR-OCT);
  • Computerized visual field;
  • Microperimetry;
  • B-Scan ultrasound (essential in the case of opaque vitreous body).
In the presence of traction on the macula, the tests allow to monitor the evolution of the condition and, if necessary, to intervene in order to prevent the formation of the macular hole. Sometimes the vitreous detaches from the retina by itself, in these cases the condition resolves spontaneously without the need for intervention.

How to intervene?

A macular hole must be treated promptly by means of a pars plana vitrectomy, which involves the removal of the vitreous body responsible for the traction on the macula. The intervention allows the restoration of central vision or, in the case macular damage has already occurred, to safeguard the residual vision.

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