Macular hole in Behçet's disease

Al-Dhibi, Hassan; Abouammoh, Marwan; Al-Harthi, Essam; Al-Gaeed, Abdulrahman; Larsson, Jorgen; Abboud, Emad; Chaudhry, Imtiaz
September 2011
Indian Journal of Ophthalmology;Sep2011, Vol. 59 Issue 5, p359
Academic Journal
To investigate the clinical features, prevalence, role of surgical intervention and the visual prognosis of macular holes (MH) in patients with Behcet's disease (BD). Materials and Methods: Retrospective study of patients with BD and MH from January 1998 to November 2008. Results: Out of 159 patients, 21 eyes of 17 patients were identifi ed with MH. The mean age was 38.59 (range 23-61) years and the mean follow-up period was 5.1 years (range 13-164 months). The prevalence of MH was 7%. Visual acuity (VA) at the time of presentation ranged from 20/70 to hand-motion. Optical coherence tomography (OCT) fi ndings revealed intraretinal cysts at the edge of the MH. The mean size of MH was 983.6 um; 52% had elevated edges, 43% had fl at edges and only one eye (5%) was closed postoperatively. Fluorescein angiography (FA) was consistent with macular ischemia in 76% of the cases. Human leukocyte antigen (HLA) B51 association was found in 14 of the 15 patients investigated. Six patients (out of 17) underwent pars plana vitrectomy. The fi nal VA on their last follow-up ranged from 20/70 to 2/200. Surgical intervention for MH did not result in any visual improvement as compared to non-operated eyes. One patient lost vision completely due to elevated intraocular pressure post vitrectomy and silicon oil tamponade. Conclusions: MH in patients with BD may lead to signifi cant visual disability. Surgical intervention does not seem to have any potential benefi cial eff ect on the VA, probably due to signifi cant macular ischemia and sequelae from the ocular infl ammation.


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