Purpose: To describe long-term changes in the vitreomacular relationship in normal fellow eyes of patients with unilateral idiopathic macular holes (MHs). Methods: This is a retrospective, observational case series. The medical records of patients who underwent surgery for idiopathic MHs between May 2000 and December 2010 were reviewed. Patients who had clinically normal fellow eyes and underwent 12 months or more of follow-up were included. The vitreomacular relationship in the fellow eyes was evaluated using optical coherence tomography (OCT) and slit-lamp biomicroscopy. Results: The study included 153 patients with a mean age of 65.5 years and a mean follow-up of 33.5 months (range, 12-121). The incidence of vitreomacular attachments evaluated by OCT was 52% (80 eyes) at initial examination, which decreased to 41, 37 and 23% at 1, 2 and 3 years after the initial examination, respectively. Of the 80 eyes with vitreomacular attachments at initial examination, 40 (50%) still had vitreomacular attachments at the final visit. Of the remaining 40 eyes in which vitreomacular separation occurred during follow-up, 11 (28%) developed an MH, with a mean interval of 45 months. None of the eyes with vitreomacular separation at presentation developed an MH. Conclusion: This largest series of fellow eyes of MHs followed by OCT shows that, at presentation, about half of the patients already have premacular vitreous detachment and therefore no risk of MH, and that second MH develops in about 30% in the process of vitreomacular separation, which evolves over a prolonged period.

1.
Trempe CL, Weiter JJ, Furukawa H: Fellow eyes in cases of macular hole. Biomicroscopic study of the vitreous. Arch Ophthalmol 1986;104:93-95.
2.
Bronstein MA, Trempe CL, Freeman HM: Fellow eyes of eyes with macular holes. Am J Ophthalmol 1981;92:757-761.
3.
Morgan CM, Schatz H: Involutional macular thinning. A pre-macular hole condition. Ophthalmology 1986;93:153-161.
4.
Akiba J, Kakehashi A, Arzabe CW, Trempe CL: Fellow eyes in idiopathic macular hole cases. Ophthalmic Surg 1992;23:594-597.
5.
Fisher YL, Slakter JS, Yannuzzi LA, Guyer DR: A prospective natural history study and kinetic ultrasound evaluation of idiopathic macular holes. Ophthalmology 1994;101:5-11.
6.
Lewis ML, Cohen SM, Smiddy WE, Gass JD: Bilaterality of idiopathic macular holes. Graefes Arch Clin Exp Ophthalmol 1996;234:241-245.
7.
Ezra E, Wells JA, Gray RH, Kinsella FM, Orr GM, Grego J, Arden GB, Gregor ZJ: Incidence of idiopathic full-thickness macular holes in fellow eyes. A 5-year prospective natural history study. Ophthalmology 1998;105:353-359.
8.
Chew EY, Sperduto RD, Hiller R, Nowroozi L, Seigel D, Yanuzzi LA, Burton TC, Seddon JM, Gragoudas ES, Haller JA, Blair NP, Farber M: Clinical course of macular holes: the eye disease case-control study. Arch Ophthalmol 1999;117:242-246.
9.
Kumagai K, Ogino N, Hangai M, Larson E: Percentage of fellow eyes that develop full-thickness macular hole in patients with unilateral macular hole. Arch Ophthalmol 2012;130:393-394.
10.
Gaudric A, Haouchine B, Massin P, Paques M, Blain P, Erginay A: Macular hole formation: new data provided by optical coherence tomography. Arch Ophthalmol 1999;117:744-751.
11.
Haouchine B, Massin P, Gaudric A: Foveal pseudocyst as the first step in macular hole formation: a prospective study by optical coherence tomography. Ophthalmology 2001;108:15-22.
12.
Chan A, Duker JS, Schuman JS, Fujimoto JG: Stage 0 macular holes: observations by optical coherence tomography. Ophthalmology 2004;111:2027-2032.
13.
Niwa H, Terasaki H, Ito Y, Miyake Y: Macular hole development in fellow eyes of patients with unilateral macular hole. Am J Ophthalmol 2005;140:370-375.
14.
Takahashi A, Yoshida A, Nagaoka T, Kagokawa H, Kato Y, Takamiya A, Sato E, Yokota H, Ishiko S, Hirokawa H: Macular hole formation in fellow eyes with a perifoveal posterior vitreous detachment of patients with a unilateral macular hole. Am J Ophthalmol 2011;151:981-989.
15.
Kumagai K, Hangai M, Larson E, Ogino N: Vitreoretinal interface and foveal deformation in asymptomatic fellow eyes of patients with unilateral macular holes. Ophthalmology 2011;118:1638-1644.
16.
Gass JD: Reappraisal of biomicroscopic classification of stages of development of a macular hole. Am J Ophthalmol 1995;119:752-759.
17.
Uchino E, Uemura A, Ohba N: Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Arch Ophthalmol 2001;119:1475-1479.
18.
Spaide RF, Wong D, Fisher Y, Goldbaum M: Correlation of vitreous attachment and foveal deformation in early macular hole states. Am J Ophthalmol 2002;133:226-229.
19.
Johnson MW: Perifoveal vitreous detachment and its macular complications. Trans Am Ophthalmol Soc 2005;103:537-567.
20.
Van Newkirk MR, Gass JD, Callanan D, Byrne SF, Hughes JR: Follow-up and ultrasonographic examination of patients with macular pseudo-operculum. Am J Ophthalmol 1994;117:13-18.
21.
Itakura H, Kishi S: Evolution of vitreomacular detachment in healthy subjects. JAMA Ophthalmol 2013;131:1348-1352.
22.
Johnson MW: Posterior vitreous detachment: evolution and complications of its early stages. Am J Ophthalmol 2010;149:371-382.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.