Pathophysiology of macular hole formation
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.
