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Treatment outcomes of macular holes in the setting of uveitis: a scoping review

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Abstract

Objective

We conducted a systematic review to evaluate the outcome of macular hole (MH) treatment in eyes with uveitis.

Data source

We searched PubMed and Embase databases from inception through August 15, 2021.

Study selection

We included eyes with MHs secondary to uveitis that were managed medically or underwent pars plana vitrectomy (PPV). We excluded eyes with idiopathic MH and those secondary to causes other than uveitis.

Results

Of 27 articles, we identified 86 eyes with MH secondary to uveitis that received either conservative medical treatment alone or PPV with adequate follow-up. The mean (± SD) age of patients included in this review was 46.6 (± 16.8) years; 60.5% were males. The most common etiology of uveitis was Behçet’s disease (34.6%) and toxoplasmosis (19.7%). The most common anatomical location of uveitis was posterior (59.3%) followed by panuveitis (35.2%). The mean (± SD) baseline LogMAR vision was 1.1 (± 0.5). Conservative medical treatment was employed in 34.9%, while PPV was performed in 65.1% of eyes. Overall, the mean (SD) LogMAR vision improved from 1.1 (± 0.5) at baseline to 0.7 (± 0.5) after treatment. Inflammation-related MHs were closed in 40% of eyes after conservative therapy and in 87.5% of eyes after PPV. Visual improvement occurred in most eyes (83.9%) that had successful closure of their MH.

Conclusions

Visual improvement occurs in most eyes that had successful closure of their inflammation-related MH. Conservative medical control of uveitis may lead to closure of inflammation-related MHs and is an important step prior to surgery, if required. Surgical intervention for inflammation-related MHs is associated with good functional and anatomical results.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Assiut University Hospitals, Assiut, Egypt

    Mohamed Kamel Soliman & Dalia M. Tohamy

  2. Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Ahmed B. Sallam

  3. University Hospitals Eye Institute/Department of Ophthalmology and Visual Sciences, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Tarek Tabbaa & Shree K. Kurup

Authors
  1. Mohamed Kamel Soliman
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  2. Dalia M. Tohamy
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  3. Ahmed B. Sallam
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  4. Tarek Tabbaa
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  5. Shree K. Kurup
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Corresponding author

Correspondence to Shree K. Kurup.

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The aim of this topical collection is to provide up-to-date information about macular holes (MHs), discuss novel techniques used to enhance the closure rates of MHs, and describe various approaches for management of challenging cases

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Soliman, M.K., Tohamy, D.M., Sallam, A.B. et al. Treatment outcomes of macular holes in the setting of uveitis: a scoping review. Graefes Arch Clin Exp Ophthalmol 260, 2079–2086 (2022). https://doi.org/10.1007/s00417-022-05590-0

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  • DOI: https://doi.org/10.1007/s00417-022-05590-0

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