Ramos LM, Perera ME, Hernández MR, Hernández RH, Hernández SJR, Padilla GCM

Language: Spanish
References: 0
Page: 55-71
PDF size: 194.81 Kb.

ABSTRACT

Objective: identify the appearance of early signs of the development of idiopathic macular hole in the contralateral eye using optical coherence tomography.
Methods: a prospective longitudinal descriptive study was conducted of a case series. The study sample was 208 eyes of 104 patients diagnosed with idiopathic macular hole attending outpatient consultation at the Retina Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from December 2008 to December 2011, after which period the patients were followed-up for five years. Evaluation was carried out of demographic variables, best corrected visual acuity and macular hole stage by optical coherence tomography, determining the stability, progression or regression of findings one and five years later in the contralateral eye. Statistical analysis was based on percentage and frequency comparisons, using the chi square statigram with a significance level of 95 %.
Results: mean age was 65.8 years. Female sex prevailed. At the start of the study, 43.3 % of the contralateral eyes presented alterations in the vitreo-macular interface. Significant differences were found between evolution at one and five years (p= 0.000) regarding the distribution of cases in the various stages. Stability was 78.3 % at one year and 54.6 % at five. Progression to more advanced stages was scant, with similar values in the two study periods (8.2 % and 7.2 %, respectively). Regression was 13.4 % at one year and 38.1 % at five. Posterior detachment of the entire vitreous was present in more than 60 % of the eyes at the end of the study. Full thickness idiopathic macular hole developed in 4.8% of the contralateral eyes. There was vision reduction in patients with progression to more advanced stages (p= 0.001).
Conclusions: optical coherence tomography is an effective diagnostic method to evaluate anatomical changes in patients with idiopathic macular hole. Periodic followup is required for early determination of the most appropriate surgical management to achieve optimal visual recovery, since this is the second eye affected.