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Macular Hole F.Fazel:MD

Macular Hole F.Fazel:MD. Pathophysiology of MH. Trauma Laser treatment Cystoid macular edema Inflammation Retinal vascular disease Retinal detachment Age-related primary idiopathic. Idiopathic MH. Seven decade Predominantly female(67%-91%) Younger age in myopes 1%-25% bilatera.

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Macular Hole F.Fazel:MD

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  1. Macular HoleF.Fazel:MD

  2. Pathophysiologyof MH • Trauma • Laser treatment • Cystoid macular edema • Inflammation • Retinal vascular disease • Retinal detachment • Age-related primary idiopathic

  3. Idiopathic MH • Seven decade • Predominantly female(67%-91%) • Younger age in myopes • 1%-25% bilatera

  4. Pathophysiology • Anteroposterior transvitreal traction????... • Tangential traction of cortical vitreous

  5. Staging

  6. Staging 1:impendiing MH(foveal &foveolar detached) 2:small fullthicknes MH)<400M) 3:fullthickness MH(>400M) 4:Complete PVD

  7. Signs & symptomsstage 1 • Mild Central visual loss &metamorphopsia • Loss of foveal depression • Yellow spot or yellow ring • 50% resolved spontaneously • 50% progress to stage 2

  8. Signs & sympomsstage 2-3 • Full thikness hole • Vision loss • Annular neurosensory detachment • Absolute scotoma((watzke-allen sign)

  9. Sign & symptomsstage4 • Complete PVD (weiss ring)

  10. Fluorescein Angiography • Circular transmission defect(stage 2-3-4) • Loss of xanthophyll & RPE atrophy

  11. OCT • IS GOLD STANDARD IN DIAGNOSIS AND STAGING

  12. Stage 1

  13. Stage 2

  14. Stage 3

  15. Stage 4

  16. Management • Stage 1:fallow up • Stage 2-4:vitrectomy +gas injection(90%-100% hole closure)

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