FLUORESCEIN ANGIOGRAPHIC CHARACTERISTICS OF MACULAR HOLES BEFORE AND AFTER VITRECTOMY WITH TRANSFORMING GROWTH-FACTOR-BETA-2

We evaluated the fluorescein angiographic features of full-thickness m acular holes before and after vitrectomy, fluid-gas exchange, and inst illation of transforming growth factor beta-2 in 43 eyes in a masked f ashion to evaluate the angiographic characteristics of macular holes p reoperatively and the changes that occur with successful and unsuccess ful closure of the macular hole. Hyperfluoreseence was present in the base of the macular hole preoperatively in 34 of 43 eyes (79.1%), was questionable in eight of 43 eyes (18.6%), and was definitely absent in only one of 43 eyes (2.3%). The hyperfluorescence in the base of the macular hole disappeared in 19 of 20 eyes (95%) with successful closur e of the macular hole (P < .00001) and appeared to be caused by blocke d fluorescence at the site of the macular hole. The photographic featu res of eyes with unsuccessful closure of the macular hole changed litt le, except that the size of the cuff of neurosensory detachment around the hole increased and was associated with decreased postoperative vi sual acuity. These angiographic changes support the presence of a glia l tissue plug bridging a small defect in the fovea of eyes with succes sful closure of a macular hole.