Low Rate of Fellow Eye Macular Hole Development During Long Term Follow Up

Patients who undergo surgery for idiopathic full-thickness macular hole have a low likelihood of developing a macular hole in the fellow eye.

In patients who undergo surgery for an idiopathic full-thickness macular hole (FTMH), the rate of FTMH development in the fellow eye is low but significant, according to a study published in Clinical Ophthalmology.

Researchers conducted a single-site, single-provider, retrospective consecutive case series of patients who underwent surgery for an idiopathic FTMH between 2003 and 2014 and had at least 5 years of follow up in their electronic medical records to estimate the long-term rate of fellow eye full-thickness macular hole development. 

A total of 77 patients (77% women, 23% men; mean age, 65.9±6.7 years) were included in the final analysis. The average follow-up duration was 11.1±4.5 years.

The researchers report a rate of fellow eye FTMH of 2.6% at 1 year, 5.2% at 3 years, 9.1% at 6 years, and 9.1% as of final follow up. The corresponding incidence (new cases/population-year) was 2.6% at 1 year, 1.3% at 3 years, and 1.0% at 6 years. 

This single site, single provider, consecutive case series identified the rate of FTMH in the fellow eye to be 9.1% over an average follow-up of 11.1 years.

The team observed no significant difference in visual outcomes between primary eyes and fellow eyes. They also observed no significant difference in gender, age, ocular comorbidities, refractive error, phakic status, and visual acuity between patients who developed a full-thickness macular hole in the fellow eye and those who did not.

“This single site, single provider, consecutive case series identified the rate of FTMH in the fellow eye to be 9.1% over an average follow-up of 11.1 years. The rate may stabilize after post-operative year 6,” according to the researchers.

The primary limitation of the study was a high rate of patients that did not meet the inclusion criteria; only 77 out of 614 potential cases could be included. The researchers speculate this could have been due to some patients pre-dating the provider adopting the electronic medical record system, the inability of patients to return for follow up, and the survival rate of an older population.

References:

Staropoli PC, Moolani HV, Elhusseiny AM, Flynn HW Jr, Smiddy WE. Rates of fellow eye macular hole development during long term follow-up. Clin Ophthalmol. 2023;17(1):47-52. doi:10.2147/OPTH.S394933