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Pathophysiology of macular hole formation
Author(s) -
Stappler T.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0187
Subject(s) - macular hole , pathophysiology , medicine , ophthalmology , epiretinal membrane , retinal , retina , internal limiting membrane , vitreous membrane , vitrectomy , retinal detachment , pathology , neuroscience , visual acuity , biology
Summary Purpose Our understanding of the pathophysiology of macular hole development has evolved in line with a novel classification system. As novel pharmacological treatments have been introduced previously unseen interactions with the pathophysiology have been observed. Methods Histopathological correlation studies as well as the effects of novel pharmacological agents on the pathogenesis of macular holes will be presented, including rare cases of macular hole formation. Results Perifoveal PVD with vitreomacular adhesion and vitreoschisis allow cortical vitreous to remain on the retinal surface and become a scaffold for cell proliferation and form epiretinal membranes. These alter the cleavage plane for the surgeon. Pharmacological vitreolysis leads to novel and challenging clinical scenarios. The Liverpool experience will be shared. Conclusions Histopathological correlation studies demonstrate a large proportion of additional epiretinal membrane components on peeled internal limiting membranes. In pharmacological vitreolysis novel strategies in the management of macular holes will be presented.