Risk of Developing a Macular Hole

We followed up 45 eyes with early-stage idiopathic macular hole (mean period, 32 months; range, 7 to 87 months) to investigate their prognoses, especially in relation to the vitreous condition. At initial examination, 18 eyes (40%) showed vitreous separation from the fovea, and 10 (22%) developed vitreous separation during follow-up. None of these 28 eyes progressed to a fully developed macular hole during follow-up. Moreover, the macular disease was apparently improved in 23 (82%) of these eyes. However, of the remaining 27 eyes without vitreous separation from the fovea, 10 eyes (37%) progressed to a fully developed macular hole. We speculate that early-stage macular hole could be reversed by spontaneous vitreous separation from the fovea, and this chance may be greater than the risk of true macular hole formation.