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M Mansour A, Parodi M, H Uwaydat S, Charbaji S, Ascaso J, A Mansour H, Tripathy K, Marcelo Barbante Casella A. Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review. JOVR [Internet]. 2023Nov.30 [cited 2024May14];18(4):424–432. Available from: https://knepublishing.com/index.php/JOVR/article/view/14555
https://doi.org/10.18502/jovr.v18i4.14555
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authors
-
Ahmad M Mansour
Ahmad M Mansour
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
-
Maurizio Parodi
Maurizio Parodi
Department of Ophthalmology, University Vita-Salute Milan, Milan, Italy
-
Sami H Uwaydat
Sami H Uwaydat
Jones Eye Institute, University of Arkansas Medical School, Little Rock, Arkansas, USA
-
Suzanne Charbaji
Suzanne Charbaji
Charbaji Consultants, Beirut, Lebanon
-
Javier Ascaso
Javier Ascaso
Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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Hana A Mansour
Hana A Mansour
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
-
Koushik Tripathy
Koushik Tripathy
ASG Eye Hospital, Kolkata, West Bengal, India
-
Antônio Marcelo Barbante Casella
Antônio Marcelo Barbante Casella
Department of Ophthalmology, Estadual de Londrina, UEL, Londrina, PR, Brasil
Published Date
- Nov 30, 2023
Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review
Abstract
Our purpose is to review the closure time and optical coherence tomography (OCT) biomarkers that result in the non-surgical repair of idiopathic full-thickness macular holes (IFTMH). Our methodology consisted of a comprehensive literature review of the nonsurgical resolution of IFTMH followed by the calculation of the estimated closure time using the structural equation model. Forty-nine studies were found eligible yielding 181 eyes with IFTMH: 81.1% being small holes (<250 μm) with a median diameter of 166 μm. Final vision (mean 20/41) was related to initial vision (mean 20/65) and mean age (67 years). The hole diameter was correlated with initial vision and closure time (mean 3.9 months). Closure time was related to hole diameter and initial vision in the following algorithm: Closure time (month)= −0.057 + 0.008 diameter (μm) + 0.021 age (year) + 2.153 initial vision (logMAR). Biomarkers by OCT for self-closure included in decreasing frequency: pointed edge, de-turgescence of cystic macular edema (CME) with reversal of bascule bridge, and vitreomacular traction (VMT) release. The crucial function of Muller cell bridging in sealing the hole attests to its exceptional capacity for regeneration. After the hole has begun to close; however in less than 5%, a delayed restoration of the ellipsoid layer or a persistent outer foveal defect may prevent visual recovery and reopening of the hole is possible. In conclusion, eyes with small-size IFTMH and good baseline vision can have the additional option of close OCT monitoring for biomarkers of self-sealing biomarkers. When rehabilitative activity seems to be lacking, surgery is therefore mandatory.
Keywords:
Cystoid Macular Edema, Epiretinal Membrane, Macular Hole, Posterior Vitreous Detachment, Vitreomacular Traction
References
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2. Yang HS, Hong JW, Kim YJ, Kim JG, Joe SG. Characteristics of spontaneous idiopathic epiretinal membrane separation in spectral domain optical coherence tomography. Retina 2014;34:2079–2087.
3. Smiddy WE, Flynn HW Jr. Pathogenesis of macular holes and therapeutic implications. Am J Ophthalmol 2004;137:525–537.
4. Murphy DC, Al-Zubaidy M, Lois N, Scott N, Steel DH, Macular Hole Duration Study Group. The effect of macular hole duration on surgical outcomes: An individual participant data study of randomized controlled trials. Ophthalmology 2023;130:152–163.
5. Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013;120:2611–2619.
6. Wang S, Xu L, Jonas JB. Prevalence of full-thickness macular holes in urban and rural adult Chinese: The Beijing Eye Study. Am J Ophthalmol 2006;141:589–591.
7. Ali FS, Stein JD, Blachley TS, Ackley S, Stewart JM. Incidence of and risk factors for developing idiopathic macular hole among a diverse group of patients throughout the United States. JAMA Ophthalmol 2017; 135:299–305.
8. Darian-Smith E, Howie AR, Allen PL, Vote BJ. Tasmanian macular hole study: Whole populationbased incidence of full thickness macular hole. Clin Exp Ophthalmol 2016;44:812–816.
9. Forsaa VA, Lindtjørn B, Kvaløy JT, Frøystein T, Krohn J. Epidemiology and morphology of fullthickness macular holes. Acta Ophthalmologica 2018;96:397– 404.
10. Lewis ML, Cohen SM, Smiddy WE, Gass JD. Bilaterality of idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol 1996; 234:241–245.
11. The Eye Disease Case-Control Study Group. Risk factors for idiopathic macular holes. Am J Ophthalmol 1994;118:754–761.
12. Huang J, Liu X, Wu Z, Sadda S. Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010;248:1071– 1075.
13. Valentim CCS, Iyer AI, Xu C, Muste JC, Li A, Singh RP. Influence of race, ethnicity, and socioeconomic factors in idiopathic macular hole presentation and surgical outcomes. Ophthalmic Surg Lasers Imaging Retina 2022;53:333–344.
14. Chandra A, Lai M, Mitry D, Banerjee PJ, Flayeh H, Negretti G, Kumar N, Wickham L. Ethnic variation in primary idiopathic macular hole surgery. Eye 2017;31:708–712.
15. 15-Papavasileiou E, Vasalaki M, Velissaris S, Garnavou- Xirou C, Zygoura V, Theodorou O, et al. Characteristics, socioeconomic status and ethnic variations of primary idiopathic macular hole repair in vitreoretinal centers in the United Kingdom. Hell J Nucl Med 2017;20:160.
16. Parvus MN, Louis AM, Trejo Corona S, Wong TP, Major JC, Patel SB, et al. Impact of race and ethnicity on presentation and surgical outcomes of idiopathic macular holes. J Pers Med 2022;12:1518.
17. Nawrocka Vel Michalewska ZA, Nawrocka Z, Nawrocki J. Spontaneous closure of full-thickness macular holes. Ophthalmologica 2022;245:49–58.
18. Dugel PU, Tolentino M, Feiner L, Kozma P, Leroy A. Results of the 2-year Ocriplasmin for treatment for symptomatic vitreomacular adhesion including macular hole (OASIS) randomized trial. Ophthalmology 2016;123:2232–2247.
19. Haller JA, Stalmans P, Benz MS, Gandorfer A, Pakola SJ, Girach A, et al. Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: subgroup analyses from two randomized trials. Ophthalmology 2015;122:117–122.
20. Sugiyama A, Imasawa M, Chiba T, Iijima H. Reappraisal of spontaneous closure rate of idiopathic full-thickness macular holes. Open Ophthalmol J 2012;6:73–74.
21. Privat E, Tadayoni R, Gaucher D, Haouchine B, Massin P, Gaudric A. Residual defect in the foveal photoreceptor layer detected by optical coherence tomography in eyes with spontaneously closed macular holes. Am J Ophthalmol 2007;143:814–819.
22. Ang AC, Hsieh YT, Tsui MC, Lai TT, Yang CM. Idiopathic macular hole without vitreomacular separation. Ophthalmologica 2022;245:187–193.
23. Liang X, Liu W. Characteristics and risk factors for spontaneous closure of idiopathic full-thickness macular hole. J Ophthalmol 201924.
24. Garg A, Ballios BG, Yan P. Spontaneous closure of an idiopathic full-thickness macular hole: A literature review. J Vitreoretin Dis 2022;6:381–390.
25. Gonzalez-Cortes JH, Toledo-Negrete JJ, Bages- Rousselon Y, de Alba-Castilla MA, Mohamed-Hamsho J. Spontaneous closure of simultaneous idiopathic macular holes documented by spectral-domain optical coherence tomography. Retin Cases Brief Rep 2018.
26. Ohayon A, Rubowitz A. Spontaneous closure of bilateral macular holes. Am J Ophthalmol Case Rep 2019;15:100516.
27. Scassa C, Bruno M, Ripandelli G, Giusti C, Scarinci F, Cupo G. Spontaneous closure of bilateral full thickness macular holes without surgery: An eleven-year followup. Eur Rev Med Pharmacol Sci 2011;15:717–720.
28. Imasawa M, Chiba T, Iijima H. Spontaneous closure of idiopathic full-thickness macular holes in both eyes. Jpn J Ophthalmol 2010;54:507–509.
29. Bonnell AC, Prenner S, Weinstein MS, Fine HF. Macular hole closure with topical steroids. Retin Cases Brief Rep 2022;16:351–354.
30. Bringmann A, Duncker T, Jochmann C, Barth T, Duncker GIW, Wiedemann P. Spontaneous closure of small full-thickness macular holes: Presumed role of Müller cells. Acta Ophthalmol 2020;98:e447–e456.
31. Brooks HL Jr, Ozkardes C. Intentional use of topical latanoprost with resulting macular edema to help in the closure of a failed, chronic, macular hole. Am J Ophthalmol Case Rep 2022;27:101603.
32. Canamary A Jr, Rios L, Pinheiro F, Capelanes N, Regatieri C. Spontaneous closure of idiopathic fullthickness macular hole after release of vitreomacular traction observed on spectral-domain optical coherence tomography. Saudi J Ophthalmol 2022;35:362–364.
33. da Costa DR, Braga PGO, Ariello LE, Zacharias LC. Spontaneous closure of a chronic full-thickness idiopathic macular hole after Irvine-Gass syndrome resolution. BMC Ophthalmol 2022;22:132.
34. Ebato K, Kishi S. Spontaneous closure of macular hole after posterior vitreous detachment. Ophthalmic Surg Lasers 2000;31:245–247.
35. Elhusseiny AM, Smiddy WE, Flynn HW, Schwartz SG. Case series of recurring spontaneous closure of macular hole. Case Rep Ophthalmol Med 2019;2398342.
36. Feria Anzaldo E, El Hamichi S, Gold A, Latiff A, Berrocal AM, Murray T. Case series: Small full-thickness macular hole treated with topical dorzolamide and bevacizumab intravitreal injections. Optom Vis Sci 2021;98:1408– 1412.
37. García Fernández M, Castro Navarro J. Spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole: A case report. J Med Case Rep 2012;6:169.
38. Kokame GT, Johnson MW, Lim J, Flynn HW, de Carlo T, Yannuzzi N, et al. Closure of full-thickness macular holes associated with macular edema with medical therapy. Ophthalmologica 2022;245:179–186.
39. Mansour HA, Uwaydat SH, Parodi M, Jürgens I, Smiddy W, Ellabban AA, et al; Collaborators of the nonsurgical resolution of macular hole study group. Recovery course of foveal microstructure in the nonsurgical resolution of full-thickness macular hole. Graefes Arch Clin Exp Ophthalmol 2022;260:3173–3183.
40. Michalewska Z, Cisiecki S, Sikorski B, Michalewski J, Kałuzny JJ, Wojtkowski M, Jerzy Nawrocki J. Spontaneous closure of stage III and IV idiopathic fullthickness macular holes; A two-case report. Graefes Arch Clin Exp Ophthalmol 2008;246:99–104.
41. Morawski K, Jędrychowska-Jamborska J, Kubicka- Trząska A, Romanowska-Dixon B. The analysis of spontaneous closure mechanisms and regeneration of retinal layers of a full-thickness macular hole: Relationship with visual acuity improvement. Retina 2016; 36:2132–2139.
42. Nicolai M, Franceschi A, De Turris S, Rosati A, Pelliccioni P, Pirani V, et al. Long-term improvement of retinal sensitivity after macular hole surgery over at least 9-year-old follow-up: A case series. Graefes Arch Clin Exp Ophthalmol 2020;258:1655–1662.
43. Niffenegger JH, Fong DS, Wong KL, Modjtahedi BS. treatment of secondary full-thickness macular holes with topical therapy. Ophthalmol Retina 2020;4:695– 699.
44. Ohayon A, Rubowitz A. Spontaneous closure of bilateral macular holes. Am J Ophthalmol Case Rep 2019;15:100516.
45. Preti RC, Zacharias LC, Cunha LP, Monteiro MLR, Sarraf D. Spontaneous macular hole closure after posterior vitreous detachment in an eye with hyperreflective OCT stress line. Am J Ophthalmol Case Rep 2020;20:100950.
46. Richards PJ, Kulkarni AD, Nork TM, Leys M, Hinkle D, Conlin KA, et al. Nonsurgical resolution of full thickness macular holes without vitreomacular traction. Retin Cases Brief Rep 2023;17:584–587.
47. Scassa C, Bruno M, Ripandelli G, Giusti C, Scarinci F, Cupo G. Spontaneous closure of bilateral full thickness macular holes without surgery: An eleven-year followup. Eur Rev Med Pharmacol Sci 2011;15:717–720.
48. Scupola A, Tiberti AC, Sasso P, Mastrocola A, Berarducci A, Bozzoni Pantaleoni F, et al. SD-OCT imaging of idiopathic macular holes with spontaneous closure. Ophthalmic Surg Lasers Imaging 2012;43:e14– e17. doi: 10.3928/15428877-20120216-01.
49. Sheng Y, Jain M, Sahoo N, Reddy N, Tyagi M, Narula R, et al. Medical therapy for large idiopathicfull-thickness macular holes. Retin Cases Brief Rep 2023:10.1097/ICB.0000000000001445.
50. Small KW, Avetisjan J, Shaya FS. Closure of macular holes with topical therapy. J Vitreoretin Dis 2022;7:109–115.
51. Sokol JT, Schechet SA, Komati R, Eliott D, Vavvas DG, Kaplan RI, et al. Macular hole closure with medical treatment. Ophthalmol Retina 2021;5:711–713.
52. Tornambe PE. Macular hole genesis- the hydration theory. Retina 2003;23:421–424.
53. Uwaydat SH, Mansour A, Ascaso FJ, Parodi MB, Foster R, Smiddy WE, et al. Clinical characteristics of full thickness macular holes that closed without surgery. Brit J Ophthalmol 2022;106:1463–1468.
54. Weber A, Suppiger TS, Hasler PW. two cases of macular hole closure with topical medical treatment. KLINISCHE MONATSBLATTER FUR AUGENHEILKUNDE 2023;240:553–555.
55. Win PH, Young TA. Spontaneous macular hole closure in bilateral macular holes. Semin Ophthalmol 2007;22:167–169.
56. Abdulkarem M, Al-Muhaylib AA, AlAkeely AG. Spontaneous closure of stage 3 full-thickness macular hole after vitreomacular traction release in a renal transplant patient -A case report. Indian J. Transplant. 2020;14:257–259.
57. Liu W, Grzybowski A. Current management of traumatic macular holes. J Ophthalmol 2017;2017:1748135.
58. Guyer DR, Green WR, de Bustros S, Fine SL. Histopathologic features of idiopathic macular holes and cysts. Retina 1991;11:446–451.
2. Yang HS, Hong JW, Kim YJ, Kim JG, Joe SG. Characteristics of spontaneous idiopathic epiretinal membrane separation in spectral domain optical coherence tomography. Retina 2014;34:2079–2087.
3. Smiddy WE, Flynn HW Jr. Pathogenesis of macular holes and therapeutic implications. Am J Ophthalmol 2004;137:525–537.
4. Murphy DC, Al-Zubaidy M, Lois N, Scott N, Steel DH, Macular Hole Duration Study Group. The effect of macular hole duration on surgical outcomes: An individual participant data study of randomized controlled trials. Ophthalmology 2023;130:152–163.
5. Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013;120:2611–2619.
6. Wang S, Xu L, Jonas JB. Prevalence of full-thickness macular holes in urban and rural adult Chinese: The Beijing Eye Study. Am J Ophthalmol 2006;141:589–591.
7. Ali FS, Stein JD, Blachley TS, Ackley S, Stewart JM. Incidence of and risk factors for developing idiopathic macular hole among a diverse group of patients throughout the United States. JAMA Ophthalmol 2017; 135:299–305.
8. Darian-Smith E, Howie AR, Allen PL, Vote BJ. Tasmanian macular hole study: Whole populationbased incidence of full thickness macular hole. Clin Exp Ophthalmol 2016;44:812–816.
9. Forsaa VA, Lindtjørn B, Kvaløy JT, Frøystein T, Krohn J. Epidemiology and morphology of fullthickness macular holes. Acta Ophthalmologica 2018;96:397– 404.
10. Lewis ML, Cohen SM, Smiddy WE, Gass JD. Bilaterality of idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol 1996; 234:241–245.
11. The Eye Disease Case-Control Study Group. Risk factors for idiopathic macular holes. Am J Ophthalmol 1994;118:754–761.
12. Huang J, Liu X, Wu Z, Sadda S. Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010;248:1071– 1075.
13. Valentim CCS, Iyer AI, Xu C, Muste JC, Li A, Singh RP. Influence of race, ethnicity, and socioeconomic factors in idiopathic macular hole presentation and surgical outcomes. Ophthalmic Surg Lasers Imaging Retina 2022;53:333–344.
14. Chandra A, Lai M, Mitry D, Banerjee PJ, Flayeh H, Negretti G, Kumar N, Wickham L. Ethnic variation in primary idiopathic macular hole surgery. Eye 2017;31:708–712.
15. 15-Papavasileiou E, Vasalaki M, Velissaris S, Garnavou- Xirou C, Zygoura V, Theodorou O, et al. Characteristics, socioeconomic status and ethnic variations of primary idiopathic macular hole repair in vitreoretinal centers in the United Kingdom. Hell J Nucl Med 2017;20:160.
16. Parvus MN, Louis AM, Trejo Corona S, Wong TP, Major JC, Patel SB, et al. Impact of race and ethnicity on presentation and surgical outcomes of idiopathic macular holes. J Pers Med 2022;12:1518.
17. Nawrocka Vel Michalewska ZA, Nawrocka Z, Nawrocki J. Spontaneous closure of full-thickness macular holes. Ophthalmologica 2022;245:49–58.
18. Dugel PU, Tolentino M, Feiner L, Kozma P, Leroy A. Results of the 2-year Ocriplasmin for treatment for symptomatic vitreomacular adhesion including macular hole (OASIS) randomized trial. Ophthalmology 2016;123:2232–2247.
19. Haller JA, Stalmans P, Benz MS, Gandorfer A, Pakola SJ, Girach A, et al. Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: subgroup analyses from two randomized trials. Ophthalmology 2015;122:117–122.
20. Sugiyama A, Imasawa M, Chiba T, Iijima H. Reappraisal of spontaneous closure rate of idiopathic full-thickness macular holes. Open Ophthalmol J 2012;6:73–74.
21. Privat E, Tadayoni R, Gaucher D, Haouchine B, Massin P, Gaudric A. Residual defect in the foveal photoreceptor layer detected by optical coherence tomography in eyes with spontaneously closed macular holes. Am J Ophthalmol 2007;143:814–819.
22. Ang AC, Hsieh YT, Tsui MC, Lai TT, Yang CM. Idiopathic macular hole without vitreomacular separation. Ophthalmologica 2022;245:187–193.
23. Liang X, Liu W. Characteristics and risk factors for spontaneous closure of idiopathic full-thickness macular hole. J Ophthalmol 201924.
24. Garg A, Ballios BG, Yan P. Spontaneous closure of an idiopathic full-thickness macular hole: A literature review. J Vitreoretin Dis 2022;6:381–390.
25. Gonzalez-Cortes JH, Toledo-Negrete JJ, Bages- Rousselon Y, de Alba-Castilla MA, Mohamed-Hamsho J. Spontaneous closure of simultaneous idiopathic macular holes documented by spectral-domain optical coherence tomography. Retin Cases Brief Rep 2018.
26. Ohayon A, Rubowitz A. Spontaneous closure of bilateral macular holes. Am J Ophthalmol Case Rep 2019;15:100516.
27. Scassa C, Bruno M, Ripandelli G, Giusti C, Scarinci F, Cupo G. Spontaneous closure of bilateral full thickness macular holes without surgery: An eleven-year followup. Eur Rev Med Pharmacol Sci 2011;15:717–720.
28. Imasawa M, Chiba T, Iijima H. Spontaneous closure of idiopathic full-thickness macular holes in both eyes. Jpn J Ophthalmol 2010;54:507–509.
29. Bonnell AC, Prenner S, Weinstein MS, Fine HF. Macular hole closure with topical steroids. Retin Cases Brief Rep 2022;16:351–354.
30. Bringmann A, Duncker T, Jochmann C, Barth T, Duncker GIW, Wiedemann P. Spontaneous closure of small full-thickness macular holes: Presumed role of Müller cells. Acta Ophthalmol 2020;98:e447–e456.
31. Brooks HL Jr, Ozkardes C. Intentional use of topical latanoprost with resulting macular edema to help in the closure of a failed, chronic, macular hole. Am J Ophthalmol Case Rep 2022;27:101603.
32. Canamary A Jr, Rios L, Pinheiro F, Capelanes N, Regatieri C. Spontaneous closure of idiopathic fullthickness macular hole after release of vitreomacular traction observed on spectral-domain optical coherence tomography. Saudi J Ophthalmol 2022;35:362–364.
33. da Costa DR, Braga PGO, Ariello LE, Zacharias LC. Spontaneous closure of a chronic full-thickness idiopathic macular hole after Irvine-Gass syndrome resolution. BMC Ophthalmol 2022;22:132.
34. Ebato K, Kishi S. Spontaneous closure of macular hole after posterior vitreous detachment. Ophthalmic Surg Lasers 2000;31:245–247.
35. Elhusseiny AM, Smiddy WE, Flynn HW, Schwartz SG. Case series of recurring spontaneous closure of macular hole. Case Rep Ophthalmol Med 2019;2398342.
36. Feria Anzaldo E, El Hamichi S, Gold A, Latiff A, Berrocal AM, Murray T. Case series: Small full-thickness macular hole treated with topical dorzolamide and bevacizumab intravitreal injections. Optom Vis Sci 2021;98:1408– 1412.
37. García Fernández M, Castro Navarro J. Spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole: A case report. J Med Case Rep 2012;6:169.
38. Kokame GT, Johnson MW, Lim J, Flynn HW, de Carlo T, Yannuzzi N, et al. Closure of full-thickness macular holes associated with macular edema with medical therapy. Ophthalmologica 2022;245:179–186.
39. Mansour HA, Uwaydat SH, Parodi M, Jürgens I, Smiddy W, Ellabban AA, et al; Collaborators of the nonsurgical resolution of macular hole study group. Recovery course of foveal microstructure in the nonsurgical resolution of full-thickness macular hole. Graefes Arch Clin Exp Ophthalmol 2022;260:3173–3183.
40. Michalewska Z, Cisiecki S, Sikorski B, Michalewski J, Kałuzny JJ, Wojtkowski M, Jerzy Nawrocki J. Spontaneous closure of stage III and IV idiopathic fullthickness macular holes; A two-case report. Graefes Arch Clin Exp Ophthalmol 2008;246:99–104.
41. Morawski K, Jędrychowska-Jamborska J, Kubicka- Trząska A, Romanowska-Dixon B. The analysis of spontaneous closure mechanisms and regeneration of retinal layers of a full-thickness macular hole: Relationship with visual acuity improvement. Retina 2016; 36:2132–2139.
42. Nicolai M, Franceschi A, De Turris S, Rosati A, Pelliccioni P, Pirani V, et al. Long-term improvement of retinal sensitivity after macular hole surgery over at least 9-year-old follow-up: A case series. Graefes Arch Clin Exp Ophthalmol 2020;258:1655–1662.
43. Niffenegger JH, Fong DS, Wong KL, Modjtahedi BS. treatment of secondary full-thickness macular holes with topical therapy. Ophthalmol Retina 2020;4:695– 699.
44. Ohayon A, Rubowitz A. Spontaneous closure of bilateral macular holes. Am J Ophthalmol Case Rep 2019;15:100516.
45. Preti RC, Zacharias LC, Cunha LP, Monteiro MLR, Sarraf D. Spontaneous macular hole closure after posterior vitreous detachment in an eye with hyperreflective OCT stress line. Am J Ophthalmol Case Rep 2020;20:100950.
46. Richards PJ, Kulkarni AD, Nork TM, Leys M, Hinkle D, Conlin KA, et al. Nonsurgical resolution of full thickness macular holes without vitreomacular traction. Retin Cases Brief Rep 2023;17:584–587.
47. Scassa C, Bruno M, Ripandelli G, Giusti C, Scarinci F, Cupo G. Spontaneous closure of bilateral full thickness macular holes without surgery: An eleven-year followup. Eur Rev Med Pharmacol Sci 2011;15:717–720.
48. Scupola A, Tiberti AC, Sasso P, Mastrocola A, Berarducci A, Bozzoni Pantaleoni F, et al. SD-OCT imaging of idiopathic macular holes with spontaneous closure. Ophthalmic Surg Lasers Imaging 2012;43:e14– e17. doi: 10.3928/15428877-20120216-01.
49. Sheng Y, Jain M, Sahoo N, Reddy N, Tyagi M, Narula R, et al. Medical therapy for large idiopathicfull-thickness macular holes. Retin Cases Brief Rep 2023:10.1097/ICB.0000000000001445.
50. Small KW, Avetisjan J, Shaya FS. Closure of macular holes with topical therapy. J Vitreoretin Dis 2022;7:109–115.
51. Sokol JT, Schechet SA, Komati R, Eliott D, Vavvas DG, Kaplan RI, et al. Macular hole closure with medical treatment. Ophthalmol Retina 2021;5:711–713.
52. Tornambe PE. Macular hole genesis- the hydration theory. Retina 2003;23:421–424.
53. Uwaydat SH, Mansour A, Ascaso FJ, Parodi MB, Foster R, Smiddy WE, et al. Clinical characteristics of full thickness macular holes that closed without surgery. Brit J Ophthalmol 2022;106:1463–1468.
54. Weber A, Suppiger TS, Hasler PW. two cases of macular hole closure with topical medical treatment. KLINISCHE MONATSBLATTER FUR AUGENHEILKUNDE 2023;240:553–555.
55. Win PH, Young TA. Spontaneous macular hole closure in bilateral macular holes. Semin Ophthalmol 2007;22:167–169.
56. Abdulkarem M, Al-Muhaylib AA, AlAkeely AG. Spontaneous closure of stage 3 full-thickness macular hole after vitreomacular traction release in a renal transplant patient -A case report. Indian J. Transplant. 2020;14:257–259.
57. Liu W, Grzybowski A. Current management of traumatic macular holes. J Ophthalmol 2017;2017:1748135.
58. Guyer DR, Green WR, de Bustros S, Fine SL. Histopathologic features of idiopathic macular holes and cysts. Retina 1991;11:446–451.