Types of macular hole closure and their clinical implications

Aims: To evaluate the clinical significance of macular hole closure types assessed by optical coherence tomography (OCT). Methods: This study involved 34 eyes of 32 patients who had undergone anatomically successful idiopathic macular hole surgery. The closed macular holes were categorised into two patterns based on OCT; type 1 closure ( closed without foveal neurosensory retinal defect) and type 2 closure ( closed with foveal neurosensory retinal defect). Association between visual prognosis, type of hole closure, and possible prognostic factors were analysed. Results: 19 eyes (61.3%) were classified into the type 1 closure and 12 eyes (38.7%) into the type 2 closure. The extent of postoperative visual improvement of type 1 closure group was larger than that of type 2 closure group ( p= 0.002). The preoperative macular hole size of type 2 closure group was significantly larger than that of type 1 closure group ( p= 0.006). The duration of symptoms was positively correlated with the preoperative macular hole size ( p= 0.01). Recurrence of macular hole occurred only in the type 2 closure group. Conclusion: The type of macular hole closure, which was influenced by the preoperative hole diameter, was associated with postoperative visual prognosis. Early detection and intervention in macular hole should be emphasised.