A macular hole can cause significant loss of central vision with blurred vision and distortions.
WHAT IS A MACULAR HOLE?
The macula is the central part of the retina. It is the part of our retina that we use to read, drive and recognize faces. The cells within the retina are in charge of catching the light energy from the outside world and changing it into chemical and electrical energy that travels through the nerve of the eye to the brain and allow us to see. The architecture of the central part of the macula, called the fovea, and the forces exerted by the vitreous gel on the retina make the fovea prone to developing a hole which can significantly affect your central vision.
WHAT ARE THE TREATMENTS FOR A MACULAR HOLE?
Macular holes vary in sizes and have the highest chance of closing if they have been present for less than 6 months. Small macular holes have a 20% chance of spontaneous closure, however if no change is noted with time, treatment is recommended.
There are 2 options for macular hole treatment:
- If the vitreous gel is still adherent in smaller holes, a proteolytic enzyme called ocriplasmin (Jetrea) can be injected into the eye that can release the adhesion of the vitreous gel to the retina and allow the hole to close. (certain criteria have to be met in order to be a candidate)
- the gold standard is still vitrectomy surgery in order to remove the vitreous gel in the back of the eye. A membrane (called Internal Limiting Membrane) is then removed surrounding the hole as this step was found to increase the rate of macular hole closure. The eye is then filled with a gas that will stay within the eye for 2 to 3 weeks.