Materiały źródłowe

• #1 AAO Idiopathic Macular Hole Guideline Summary

  https://www.guidelinecentral.com/guideline/10150/

  Idiopathic macular holes are more common in females than in males and usually occur after age 55. […] Patients with vitreous traction, good vision, and no macular hole (stage 1-A or 1-B) should be observed without treatment, because they often remain stable or even improve. Currently, there is no evidence that treatment improves their prognosis. […] Most patients with stages 2, 3 and 4 macular holes will have a poor prognosis without treatment. The visual prognosis is good following successful macular hole closure. The benefits of treatment designed to achieve macular hole closure should be discussed. […] Early detection of a macular hole is associated with a higher closure rate after vitrectomy and better postoperative visual acuity. […] Careful removal of the internal limiting membrane (ILM) during vitrectomy surgery increases the macular hole closure rate without adversely affecting visual acuity. […] Cataract development or progression is a frequent side effect of vitrectomy surgery to repair macular holes. This risk should be discussed with patients preoperatively, and postoperative monitoring is advised.

• #2 What Is a Macular Hole? – Optometrists.org

  https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/macular-degeneration-guide/macular-diseases/what-is-a-macular-hole/

  Macular holes affect up to 4 in 1,000 people above the age of 55. […] Early detection of a macular hole can reduce your risk of permanent damage and vision loss. […] A macular hole can significantly impact your vision preventing you from enjoying your daily activities and affecting your quality of life. […] Fortunately, with early detection and treatment your clear vision can be restored. […] If you suspect you have symptoms of a macular hole, contact an eye doctor near you, who can diagnose and treat the condition. […] Some macular holes may seal by themselves, but in most cases, a surgical procedure, called a vitrectomy is performed to treat the condition and improve vision. […] Following a vitrectomy, your eye doctor will instruct you to remain in a face-down position for a day or two though in some cases when the surgical repair is more extensive, for up to two to three weeks. The face-down position is crucial for recovery, as it enables the gas bubble to efficiently press against the macula.

• #3 Macular Hole, Vitreous and Macular Surgery, Retina Services

  https://www.floridaretinainstitute.com/macular-hole.html

  A macular hole is a small break in the macula, a hole or defect that develops in the center of your eyes light-sensitive tissue, called the retina. […] With the development of a macular hole, your central vision will become blurry, wavy or distorted. […] A dark or blind spot may appear in the center of your vision. […] Sometimes a small macular hole can heal on its own. However, most macular holes require surgery. […] The surgery is called a vitrectomy with membrane peel, and it is the best way to treat a macular hole. […] During a vitrectomy with membrane peel, your retinal surgeon removes the vitreous that is pulling on your macula and removes a fine layer of tissue on the surface of the retina to aid in hole closure. […] During surgery, a gas bubble is left inside the eye and helps flatten the macular hole and support the retina while it heals.

• #4 Macular Hole – Portland Eye Care | Optometrist | Eyeglasses | Contact Lenses

  https://eyepdx.com/eye-health-conditions/macular-hole/

  A macular hole is a small break in the macula, located in the center of the eyes light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. […] A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60. […] The size of the hole and its location on the retina determine how much it will affect a persons vision. When a Stage III macular hole develops, most central and detailed vision can be lost. If left untreated, a macular hole can lead to a detached retina, a sight-threatening condition that should receive immediate medical attention. […] Although some macular holes can seal themselves and require no treatment, surgery is necessary in many cases to help improve vision. In this surgical procedure called a vitrectomy the vitreous gel is removed to prevent it from pulling on the retina and replaced with a bubble containing a mixture of air and gas. The bubble acts as an internal, temporary bandage that holds the edge of the macular hole in place as it heals.

• #5

  https://umiamihealth.org/en/bascom-palmer-eye-institute/specialties/retina-and-vitreous-diseases/macular-holes

  The macula is the part of your eye responsible for your central (reading) vision. When a hole develops in your macula, you cannot read or see clearly. You may even experience significant vision loss. If you develop this condition, you will not feel any pain. […] Macular holes can lead to significant loss of eyesight. The best way to protect yourself from this condition is through regular eye exams so your doctor can detect them early or prevent holes from forming. If you experience blurred or distorted vision, dont wait. Contact Bascom Palmer Eye Institute, part of the University of Miami Health System, right away. […] If you have a hole, your retinal specialist will find them during your exam. You and your specialist will discuss treatment options based on your age, the severity of your condition, and your tolerance for certain medications and procedures. Together, you decide on a treatment plan. Using expertise and advanced technology, our ophthalmologists achieve their main goal restoring your vision as quickly as possible.

• #6 Macular Hole & Pucker Treatment | Chattanooga, Knoxville, Tri-Cities

  https://www.southeasternretina.com/retina-conditions/macular-conditions

  A macular hole is a break that occurs when the macula is stretched or pulled, often due to a normal aging process called posterior vitreous detachment (PVD). […] In many cases, macular holes and puckers may not lead to vision problems, necessitating only regular monitoring. Your retina doctor may recommend a vitrectomy to remove the vitreous gel partially or fully and prevent macular traction in the case of macular holes. […] Following a macular hole or pucker procedure, particularly a vitrectomy, recovery typically spans several weeks. Most macular holes effectively close after a single procedure, resulting in significant improvement in blurred vision and distortion for most patients. […] Macular holes and macular puckers, if untreated, have the potential to progress into significant vision concerns, making regular monitoring and retina exams crucial.

• #7 Macular Hole vs. Macular Pucker: Symptoms, Treatment, and When Surgery Is Needed | Leading Retinal Care in South Florida | Retina Group of Florida™

  https://www.retinagroupflorida.com/blog/macular-hole-vs-macular-pucker-symptoms-treatment-and-when-surgery-is-needed

  Symptoms of a macular hole would mainly include the loss of your central vision; meaning that you would not be able to see clearly, focus your eyesight, or determine details. […] Treatment for a macular hole is surgical. A procedure known as a vitrectomy is used. This is an outpatient procedure used to provide care for a number of other eye conditions as well. Patients are typically awake for the procedure but asked not to speak or move until it is complete. […] If left untreated, yes, a macular hole will result in a permanent loss of your central vision. It is essential for anyone experiencing vision issues, especially if these issues come on relatively quickly, to seek professional care from a retina specialist.

• #8 Macular Hole – Lakewood, NJ: InVision Eye Care

  https://www.invisioneyecare.com/contents/serv/retinal-center/macular-hole

  Macular holes are easily diagnosed in our office with a careful eye exam and the use of a special test called an OCT. This is an advanced laser scanning tool that uses computers to produce magnificent images of the macula in seconds. […] Until recently a macular hole meant you stayed legally blind in that eye. Today we are able to repair a macular hole in nearly 90% of patients. The surgical procedure is called vitrectomy. Three micro openings are used to perform this procedure. The openings are so small they generally seal themselves so very often stitches are unnecessary. After surgery the patient is required to position facedown for several days. In general, while macular hole surgery is not an emergency, the sooner the procedure is done the better the visual recovery will be. We train patients who have had macular holes to monitor themselves for the relatively infrequent development of a hole in their fellow eye.

• #9 Macular Hole | Retina Consultants of Orlando

  https://www.retinaconsultantsorlando.com/macular-hole/

  The treatment for a macular hole depends on the size and stage of the hole, as well as the individuals overall eye health. […] Vitrectomy is a common surgical procedure for treating macular holes. During this procedure, the vitreous gel is removed and replaced with a gas bubble, which helps the hole to close and the retina to reattach. You will need to position your head in a specific way to allow the gas bubble to press against the macula and promote healing. Over time, the gas bubble will naturally dissolve. […] Following surgery, you may be advised to avoid certain activities that could put strain on your eyes, such as heavy lifting or straining during bowel movements. Your eye care professional will provide specific instructions to aid in the healing process. […] The recovery period after macular hole surgery can vary from person to person. It may take several weeks or months for your vision to improve. Its important to attend all follow-up appointments to monitor your progress and ensure proper healing.

• #10 Macular Hole | Eye Disorders | Ophthalmology | Area of Care | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/areas-of-care/ophthalmology/eye-disorders/macular-hole.html

  A macular hole is a small break in the macula, located in the center of the eye’s light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. […] A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60. […] Although some macular holes can seal themselves and require no treatment, surgery is necessary in many cases to help improve vision. In this surgical procedure–called a vitrectomy–the vitreous gel is removed to prevent it from pulling on the retina and replaced with a bubble containing a mixture of air and gas. […] Following surgery, patients must remain in a face-down position, normally for a day or two but sometimes for as long as two-to-three weeks. This position allows the bubble to press against the macula and be gradually reabsorbed by the eye, sealing the hole.

• #11 Macular Hole – Diagnosis and Treatment at UPMC Vision Institute

  https://www.upmc.com/services/eye/conditions/macular-hole

  Macular holes typically are treated with a surgical procedure, called a vitrectomy. During this surgery, the retina specialist removes the eyes vitreous gel to prevent it from separating from the retina and allowing other eye fluids to leak behind the retina, which can worsen the condition. […] During a vitrectomy, the vitreous is replaced with a bubble mixture of gas and air that puts pressure on the edges of the macular hole, allowing it to heal. In order for the bubble to press against the macula and seal the hole, however, a patient has to remain in a face-down position for several days. Over a period of time, the air and gas bubble is eventually reabsorbed by the eye and the vitreous cavity will refill with natural eye fluid.

• #12

  https://umiamihealth.org/en/bascom-palmer-eye-institute/specialties/retina-and-vitreous-diseases/macular-holes

  Surgery – While not every patient with macular damage needs surgery, it is successful for many. To surgically repair a hole, the retinal surgeon remove the eyes natural vitreous, a gel-like substance, and injects gas inside the eye. This gas bubble acts as an internal, temporary bandage. As the hole heals, the bubble holds the edge of the hole in place. To aid your healing, you must usually remain in a face down position for one week after surgery. This allows the bubble to press against the macula and properly seal the hole. Over two to six weeks, the bubble gradually reabsorbs as the vitreous area refills with a naturally produced fluid. […] At Bascom Palmer, every patient is considered an individual, with unique needs. Your eye care team not only evaluates your vision, they consider your medical history and your lifestyle when creating a treatment plan. If youre coping with poor vision, we instruct you about your condition and share ideas and resources to help you achieve a good quality of life.

• #13 Macular hole repair does not require face-down positioning – Mayo Clinic

  https://www.mayoclinic.org/medical-professionals/ophthalmology/news/macular-hole-repair-does-not-require-face-down-positioning/mac-20430610

  A retrospective study of 68 eyes (65 patients) indicates that macular hole surgery with broad internal limiting membrane (ILM) peeling, 20% sulfur hexafluoride (SF6) gas and no face-down positioning is highly effective in the surgical treatment of idiopathic macular holes. […] „Closure methods that eliminate the need for face-down positioning and do not compromise closure rates would reduce patient morbidity significantly, improve patient satisfaction and represent a significant advancement in surgery for macular holes,” says Dr. Iezzi. […] „Visual acuity improved in all patients who achieved successful anatomical closure,” says Dr. Iezzi, „which was approximately 95%.” This study shows that no-face-down macular hole repair is noninferior to face-down procedures, and vision can improve even when the macular hole has been present for many years.

• #14 Macular Hole | Bay Area Retina Associates

  https://www.bayarearetina.com/macular-hole

  A macular hole is a defect in the central retina (macula). Since the macula is responsible for reading vision, patients who develop a macular hole complain of distorted vision and loss of central vision in the affected eye. […] Macular holes are treated with a type of retinal microsurgery called macular hole repair. Macular hole repair is a type of vitrectomy, in which the gel inside the eye is removed and a gas bubble is placed inside the eye. […] Macular hole repair is an outpatient procedure that usually takes less than an hour. Surgery is most often performed under local anesthesia, but can be done under general anesthesia as well. […] Visual improvement after macular hole repair is gradual, since the return of retinal function requires significant healing time after hole closure. Hole closure can usually be confirmed by your BARA surgeon 3-8 weeks after surgery and vision can improve gradually up to 6 months after surgery.

• #15 Common Retinal Treatment Options – Louisiana Retina

  https://louisianaretina.com/macular-hole-causes-symptoms-treatment-in-louisiana/

  The macula is the light sensitive tissue inside the human eye that allows us to see fine details in our central vision. When a hole forms in the macula, it is known as a macular hole. This results in significant decline of the central vision. Macular holes can happen to anyone but occur much more often in older adults. […] If you experience any of these symptoms, you should notify your eye care provider immediately so they can determine if you have a macular hole. Louisiana Retina can typically provide same-day or next-day appointments in the case of emergencies. […] Treatment for macular holes involves a surgical procedure called vitrectomy. Vitrectomy is a tried-and-tested approach to treating macular holes, with a success rate of over 90-95%. During this procedure, your retina specialist will repair the hole by using a gas bubble to close the gap until it heals shut.

• #16 Macular hole | Macular Disease Foundation Australia Macular Disease Foundation Australia

  https://www.mdfoundation.com.au/about-macular-disease/other-macular-conditions/macular-hole/

  Most macular holes require surgery. […] Most macular holes require surgery. […] Your ophthalmologist will normally prefer to operate on a macular hole within a month or two of it being found. […] In most cases, surgery will stop your vision problems getting worse. […] Over 90 per cent of holes will close after surgery. […] If posturing is necessary, you’ll need to plan for this before the operation. […] If you do need to posture, you’ll usually need to spend 50 minutes out of every hour face down. […] It’s important to discuss any other medical problems that may affect your ability to posture with your ophthalmologist. […] Macular hole surgery normally helps maintain good vision. […] A key priority in managing vision loss is maintaining quality of life and independence.

• #17 Macular Hole | Retina Care Center | MD | PA | DE

  https://retinacarecenter.com/conditions/macular-hole/

  The macula is the part of the retina responsible for fine central vision necessary for reading, watching television, and recognizing faces. A macular hole is a small round opening in the macula which causes a blind spot or blurred area in the central vision. […] Vitrectomy surgery, the only treatment for a macular hole, removes the gel and scar tissue pulling on the macula which keeps the hole open. The eye is then filled with a gas bubble to help close the hole. The gas bubble will gradually dissolve over the course of 3-5 weeks. Usually, the patient is instructed to remain in a face down position for 5-10 days to keep the gas bubble in contact with the macula while the hole closes. Patients should avoid lying flat on their backs, flying, and certain types of general anesthesia while the gas bubble is in the eye. […] With surgery, the majority of macular holes close resulting in improved vision. The degree of improvement often depends on the size of the hole and the length of time the hole was present. Generally, vision does not return completely to normal even with successful repair.

• #18 Macular Hole | Bay Area Retina Associates

  https://www.bayarearetina.com/macular-hole

  Macular hole repair leads to improved vision in the vast majority of cases, with about 3/4 of eyes improving 3 or more lines on the eye chart. It is important to keep in mind that vision rarely returns to „normal” since the tissue architecture often shows residual abnormalities even after successful surgical closure. The prognosis for improved vision is worse in eyes that already have age-related tissue thinning or other macular disease prior to surgery. […] Rare complications after vitrectomy surgery include bleeding, infection, retinal tear and retinal detachment. These complications occur in 1 out of several thousand patients. More commonly, cataract may advance at a faster pace following vitrectomy. Patients who have not previously undergone cataract surgery should expect to need cataract surgery within 1-2 years of vitrectomy surgery if not sooner.

• #19 Macular hole – Macular Society

  https://www.macularsociety.org/macular-disease/macular-conditions/macular-hole/

  Post-operative care Following surgery, the eye may be sensitive, swollen and red. You will be prescribed eye drops to prevent infection and reduce inflammation. […] Posturing Posturing is a form of recovery that involves keeping the head face-down for up to two weeks after surgery to ensure the gas or oil puts pressure in the right place to help close the macular hole. If posturing is advised, equipment is available to make you more comfortable. […] You will need to attend the eye clinic out-patients department 12 weeks after surgery for assessment. It is common to review progress after three months. Following a vitrectomy you may need new glasses. If you are given a new lens prescription, do not get new glasses until the gas bubble has been absorbed. Ask your ophthalmologist for advice.

• #20 Macular Hole | VMFH

  https://www.vmfh.org/our-services/eye-care/ophthalmology/ophthalmology-services/macular-hole

  Virginia Mason Franciscan Health ophthalmologists have broad experience diagnosing and treating patients with retinal disorders, including macular hole. […] In most cases surgery is recommended to remove the vitreous gel (vitrectomy) so that it no longer pulls on the retina. […] Following surgery, at home, you may be asked to lie in a prone position, keeping your head still and facing downward. […] You also will use prescription eyedrops and be asked to wear an eye patch for one or more days. […] You will be scheduled for follow-up visits for several weeks after the surgery. […] The majority of patients 60 percent to 90 percent treated for a macular hole have a successful outcome, with the hole closing and vision retained or improved.

• #21 Macular Hole | Eye Disorders | Ophthalmology | Area of Care | SUNY Downstate

  https://www.downstate.edu/patient-care/find-treatment/areas-of-care/ophthalmology/eye-disorders/macular-hole.html

  Maintaining a face-down position is crucial to the success of the surgery. […] If you cannot remain in a face-down position for the required period after surgery, vision recovery may not be successful. People who are unable to remain in a face-down position for this length of time may not be good candidates for a vitrectomy.

• #22 Facedown Positioning is Not Necessary in Idiopathic Macular Hole Repair – Retina Today

  https://retinatoday.com/articles/2014-jan-feb/facedown-positioning-is-not-necessary-in-idiopathic-macular-hole-repair

  Facedown positioning for 3 days to 1 week after surgery for idiopathic macular hole repair remains the traditional standard of care. This is a significant source of morbidity for patients, however, as it is difficult and uncomfortable. […] A recently published retrospective consecutive case series of patients from our practice (68 eyes in 65 patients) shows that macular hole surgery can be performed without facedown positioning with results equivalent to surgery in patients who practice facedown positioning. […] We have found clear benefits with regard to safety, comfort, and patient satisfaction. […] Eliminating facedown positioning removes these obstacles. […] Our study found that phacoemulsification with intraocular lens insertion is not a crucial step in the process of repairing macular holes, as a significant proportion of the cases in our series were phakic at the time of surgery.

• #23 Macular Hole Surgery Specialists | Retina Consultants of Minnesota

  https://www.retinamn.com/retinal-conditions/macular-hole

  A macular hole is a defect in the center of the macular area of the retina. […] Macular holes are usually repaired with vitrectomy surgery. […] Surgery is recommended for most macular holes. […] At Retina Consultants of Minnesota in Minneapolis, our experienced physicians usually perform vitrectomy surgery on an outpatient basis under local anesthesia. […] The most important part of macular hole surgery is the requirement for postoperative face-down positioning. […] The amount of visual improvement varies depending on whether the macular hole closes, how long the macular hole was present, the anatomic characteristics of the macular hole, and the presence of any other ocular abnormalities that might limit vision. […] Surgery is the treatment of choice for the vast majority of macular holes. […] If the macular hole is not surgically repaired, it will typically lead to a permanent impairment in a patients central vision. […] Patients should refrain from driving while the gas bubble is present.

• #24 Macular Hole, Vitreous and Macular Surgery, Retina Services

  https://www.floridaretinainstitute.com/macular-hole.html

  Macular hole surgery often requires a face down or reading position at all times for up to a week after vitrectomy surgery. […] Your vision will usually improve with the closure of the macular hole. Maximal improvement may take several months. Final vision after hole closure depends on the size of your macular hole prior to surgery and how long the hole was there before you had surgery. […] Like any surgery, vitrectomy surgery has risks. […] Your ophthalmologist will talk about these risks and how vitrectomy surgery may help you.

• #25 2 Macular Degeneration Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/macular-degeneration-nursing-care-plans/

  Use this nursing care plan and management guide to provide care for patients with macular degeneration. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals with macular degeneration. […] Nursing management of macular degeneration involves educating the patient about the condition, its progression, and the importance of regular eye exams. Nurses can also provide support in managing visual impairments through strategies such as providing low-vision aids, promoting adequate lighting, and referring patients to vision rehabilitation services. […] The following are the nursing priorities for patients with macular degeneration: Recognize and assess macular degeneration, Monitor visual changes, Educate patients about macular degeneration, Provide support for optimizing visual function.

• #26 2 Macular Degeneration Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/macular-degeneration-nursing-care-plans/

  Goals and expected outcomes may include: The patient will regain the optimal vision possible and will adapt to permanent visual changes, The patient will be able to verbalize understanding of visual loss and diseases of the eyes, The patient will be able to regain vision to the maximum possible extent with the surgical procedure, The patient will be able to deal with the potential for permanent visual loss, The patient will maintain a safe environment with no injury noted, The patient will be able to use adaptive devices to compensate for visual loss, The patient will be compliant with the instructions given and will be able to notify the physician of emergency symptoms, The patient will be free of injury and will be able to perform activities within the parameters of sensory limitation, The patient will be able to be free of injury, The patient and/or family will be able to modify the environment to ensure patient safety.

• #27 2 Macular Degeneration Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/macular-degeneration-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with macular degeneration may include: Assessing Visual Acuity and Optimizing Visual Perception, Preventing Injuries. […] Patients with Macular Degeneration are at prone to injury due to several factors. Firstly, decreased vision, particularly central vision, can impair a patient’s ability to navigate their environment safely and increase their risk of falls and accidents. Secondly, aging can further exacerbate vision changes and lead to decreased visual acuity, making it more difficult for patients to perceive potential hazards. Lastly, the disease process itself can impact the function of the macula, leading to progressive vision loss and further increasing the risk of injury. […] Instruct the patient and/or family regarding the need to maintain a safe environment. Reduced visual acuity puts the patient at risk for injury. […] These techniques help enhance visual discrimination and reduce the potential for injury.

• #28 Macular Hole – Portland Eye Care | Optometrist | Eyeglasses | Contact Lenses

  https://eyepdx.com/eye-health-conditions/macular-hole/

  Following surgery, patients must remain in a face-down position, normally for a day or two but sometimes for as long as two-to-three weeks. This position allows the bubble to press against the macula and be gradually reabsorbed by the eye, sealing the hole. […] Maintaining a face-down position is crucial to the success of the surgery. […] If you cannot remain in a face-down position for the required period after surgery, vision recovery may not be successful.

• #29 Facedown Positioning is Not Necessary in Idiopathic Macular Hole Repair – Retina Today

  https://retinatoday.com/articles/2014-jan-feb/facedown-positioning-is-not-necessary-in-idiopathic-macular-hole-repair

  The key to successful macular hole surgery is a meticulous, complete vitrectomy. […] The results of our case series show that, using the surgical techniques described here, facedown positioning is not necessary after surgery for idiopathic macular hole closure. […] Ultimately, such a near-complete vitrectomy increases the extent of gas fill and, combined with membrane and ILM peeling, ensures success in hole closure.

• #30 Macular Hole – Retina Consultants

  https://retinaconsultants.net/diseases/macular-hole/

  Watch this video to learn how a macular hole forms and what we do to help close the hole. […] If you have a macular hole, your central vision will be diminished. Ocular coherence tomography (OCT) scanning will help you understand what is happening (see above). […] Macular holes can often be repaired with pars plana vitrectomy surgery and gas injection. Some doctors require face-down positioning after macular hole repair, while others do not. Ask your doctor about the need for face-down positioning after surgery so you can prepare. […] Some macular holes can be treated with an in-office intraocular injection that can close the macular hole in 4050% of patients without surgery. If you are a candidate, your doctor will discuss this with you. […] Schedule an evaluation with a retinal specialist to determine whether you have a macular hole and may be a candidate for pars plana vitrectomy surgery.

• #31 AAO 2023: Pediatric macular holes: Causes, characteristics, and care

  https://www.modernretina.com/view/aao-2023-pediatric-macular-holes-causes-characteristics-and-care

  Pediatric macular holes are rare and generally result from blunt trauma. […] The clinical course for the 47 patients was watchful waiting in 41 patients and spontaneous closure in 26, for a closure rate of 63%. […] Eighteen patients underwent surgery, which achieved macular hole closure in 13 for a closure rate of 72%; the holes reopened and then closed in 3 patients. […] The study findings that surgical closure was safe and effective for hole closure in 18 patients. […] A comparison of surgery and watchful waiting found no difference in closure rates as mentioned, 72% and 63%, respectively. […] Both observation and surgery resulted in significant improvements in the best-corrected visual acuity at the final follow-up visit from 20/315 preoperatively to 20/70 in the surgical patients and from 20/230 to 20/50 in the observation group. […] Given the high rates of spontaneous closure, watchful waiting for 2 to 5 months can be a reasonable approach before an invasive intervention, particularly if no other vision-threatening pathology is present.

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