Closure of Full-Thickness Macular Holes Associated with Macular Edema with Medical Therapy

Abstract

Purpose: The purpose of this study was to report the closure of macular hole without surgery in 7 cases using medical therapies.

Methods: The retrospective review of 7 cases of full-thickness macular holes, which closed after medical therapy without surgery.

Results: Seven eyes of 7 patients developed full-thickness macular holes, which initially closed on medical therapy without surgery. Six patients were kept on maintenance therapy; 1 recurred and 5 did not develop recurrence. One patient was taken off of maintenance therapy and later developed recurrent macular hole requiring macular hole surgery.

Conclusions: Medical therapy to decrease macular edema may facilitate macular hole closure and should be considered, especially for small macular holes with significant edema. Reopening of macular holes may occur after stopping topical maintenance therapy for macular edema, which occurred at 10 weeks and 9 months after maintenance therapy was discontinued or markedly tapered.

Keywords: Bevacizumab; Carbonic anhydrase inhibitors; Intravitreal injections; Ketorolac; Macular edema; Macular hole; Nepafenac; Prednisolone; Spontaneous closure; Topical nonsteroidal anti-inflammatory drugs; Topical steroids; Triamcinolone.