MACULAR HOLE

A macular hole is the formation of a hole in the macula, the central region of the retina. As a highly sensitive layer of tissue responsible for translating light signals into vision, any damage to the retina causes vision loss. Furthermore, because the macula brings clear and detailed central vision, a hole in the macula can cause the loss of central sight and even full blindness. Thus, early intervention provides the best chance of recovering central vision.

CAUSES

TRAUMATIC MACULAR HOLE

Traumatic macular hole formation occurs when a traumatic ocular injury causes a hole to form in the macula.

There tends to be no progression in the condition after the damage to the macula is done. However, this condition requires rapid treatment because it leads to the formation of dead retinal tissue after the injury. This can cause complications when restoring central vision during treatment.

VITREO-MACULAR TRACTION (VMT)

In the case of vitreo-macular traction, it is the strength of the central attachments between the vitreous body and the retina that causes the macula to tear during posterior vitreous detachment (PVD). The pull on the macula by the vitreous body gradually forms blisters underneath the retina which causes macular edema, or swelling, and cyst formation in the macula and finally, more advanced forms of macular holes.

IDIOPATHIC MACULAR HOLE

Idiopathic macular hole formation is unique in that it occurs without an underlying cause. The condition starts with the detachment of the sub-fovea or central macula from the back of the eye and eventually progresses to the formation of a macular hole. Unlike the other causes of macular holes, idiopathic macular hole formation carries a 15-20% chance of forming in both eyes.

HIGH MYOPIC MACULAR HOLE

Patients with high or severe myopia put an increased amount of stress on their eyes, leading to the rapid deterioration of their central vision through the development of a high myopic macular hole. This condition can be followed by macular or retinal detachment, which leads to further loss in central vision. The high myopic macular hole is the only type of macular hole that can lead to full blindness.

TREATMENT

The leading treatment for all types of macular hole formation is vitrectomy surgery. Depending on factors including the current size of the macular hole, how much time has passed since the formation of the macular hole, the cause of the formation of the macular hole, and the age of the patient, the closure rate of the hole after surgery can be 80% or lower for all types of macular holes.

OCC is a Canadian pioneer in combining the use of the green ICG dye and Kenalog in order to improve hole closure rates. At OCC, we also minimize complications due to the use of an ICG dye by diluting it and using it for a limited time during surgery.

Moreover, our surgical technique of performing cataract extraction alongside vitrectomy surgery allows 95% of patients to avoid needing to stay face down for two weeks after surgery. Instead, our patients only have to endure 24 to 48 hours face down post-surgery, which reduces the likelihood of bodily discomfort, neck and body strain, and nerve damage in the patient.