HUMAN AUTOLOGOUS SERUM FOR THE TREATMENT OF FULL-THICKNESS MACULAR HOLES - A PRELIMINARY-STUDY

Background: Recent studies have shown the usefulness of pars plana vit rectomy with/or without the use of transforming growth factor-beta in treating macular holes, The purpose of the present study is to test th e efficacy of autologous serum in conjunction with current surgical te chniques in the repair of stage 3 or 4 macular holes. Methods: A total of 11 eyes in nine patients with stage 3 or 4 full-thickness macular holes were treated, The patients ranged in age from 53 to 80 years (me an, 68 years). These patients were followed for 4 to 11 months (mean, 8.4 months). Preoperative best-corrected visual acuity ranged from 2/2 00 to 20/80 (mean, 20/200). A standardized pars plana vitrectomy was p erformed with removal of the posterior hyaloid and/or removal of epire tinal membranes, fluid-gas exchange. Autologous serum (0.1 ml) was ins tilled over the macular hole followed by perfluorocarbon gas tamponade and head positioning for 2 weeks. Results: All 11 (100%) of the eyes in 9 patients had resolution of the surrounding subretinal fluid and f lattening of the macular hole. All of the eyes showed an improvement o f at least two lines or more (mean, 4.7 lines) in visual acuity. Three eyes (27%) had visual acuities of 20/40 or better, and seven (64%) ha d visual acuities of 20/60 or better. No exuberant fibrosis proliferat ion was noted in any eye. Conclusion: The results of this preliminary study indicate the possible benefit of autologous serum when used in c onjunction with current surgical techniques in treating stage 3 or 4 m acular holes.