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      Types of macular hole closure and their clinical implications.

      The British Journal of Ophthalmology

      Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pigment Epithelium of Eye, pathology, Prognosis, Regression Analysis, Retinal Perforations, physiopathology, surgery, Retrospective Studies, Tomography, Treatment Outcome, Visual Acuity, Vitrectomy, methods

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          To evaluate the clinical significance of macular hole closure types assessed by optical coherence tomography (OCT). This study involved 34 eyes of 32 patients who had undergone anatomically successful idiopathic macular hole surgery. The closed macular holes were categorised into two patterns based on OCT; type 1 closure (closed without foveal neurosensory retinal defect) and type 2 closure (closed with foveal neurosensory retinal defect). Association between visual prognosis, type of hole closure, and possible prognostic factors were analysed. 19 eyes (61.3%) were classified into the type 1 closure and 12 eyes (38.7%) into the type 2 closure. The extent of postoperative visual improvement of type 1 closure group was larger than that of type 2 closure group (p=0.002). The preoperative macular hole size of type 2 closure group was significantly larger than that of type 1 closure group (p=0.006). The duration of symptoms was positively correlated with the preoperative macular hole size (p=0.01). Recurrence of macular hole occurred only in the type 2 closure group. The type of macular hole closure, which was influenced by the preoperative hole diameter, was associated with postoperative visual prognosis. Early detection and intervention in macular hole should be emphasised.

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