Abstract
BackgroundTo investigate the formation pathways of full-thickness macular hole (FTMH) in proliferative diabetic retinopathy (PDR) with fibrovascular proliferation (FVP).MethodsTwenty-one consecutive patients (21 eyes) having PDR and FVP with optical coherence tomography (OCT) available before and after FTMH formation were retrospectively reviewed. Fundus abnormalities and OCT features were studied.ResultsFour different types of FTMH formation pathways in PDR were observed. Type 1 was characterized by epiretinal membrane (ERM) and/or vitreomacular traction (VMT) inducing foveoschisis, intraretinal cysts or foveal detachment, followed by formation of a FTMH or macular hole retinal detachment (MHRD). In type 2, ERM and/or FVP induced lamellar macular hole (LMH) with foveoschisis, followed by the formation of FTMH or MHRD. Type 3 was characterized by the initial tractional retinal detachment (TRD) with foveal cysts and/or foveoschisis and the subsequent formation of MHRD. Type 4 was characterized by TRD associated with foveal thinning, ensued by the formation of MHRD. Severity and locations of FVP varied with different types. Eyes with MHRD had poorer best-corrected visual acuity, higher proportion of active FVP, and higher rate of TRD.ConclusionFour types of FTMH formation pathways in PDR were identified and were quite different from those in idiopathic conditions. Spontaneous closure of FTMHs in PDR might be observed. The activity, severity and locations of FVP varied in PDR eyes destined to develop FTMHs.
Macular hole formation following panretinal photocoagulation in proliferative diabetic retinopathy
