Abstract:

Idiopathic macular hole (IMH) is a common eye disease of middle-aged and elderly people. With the popularization of imaging technologies like optical coherence tomography and vitreous surgery technology, people′s perception and treatment methods of this disease are also constantly enriched, and the surgical closure rate of the hole is also significantly improved. However, there are still many problems to be clarified in the clinical aspect of this disease. For example, the role of systemic factors in the pathogenesis of macular hole is unknown. How do gender-related factors affect the clinical manifestations of macular hole? What are the essential differences between stage 3 and stage 4 holes? What are the prognostic factors of traditional internal limiting membrane peeling and air filling surgery? In addition, in contrast to the emphasis on the anatomical outcomes, the research on the functional prognosis of the disease other than vision is still insufficient, such as metamorphopsia, retinal sensitivity in the operation area, evaluation of visual related quality of life, etc. Moreover, the occurrence of iatrogenic retinal breaks under the condition of micro-incision surgery is also one of the concerns in regard of surgical prognosis. Finally, in recent years, the development of internal limiting membrane flap technology leads to a new topic whether both the anatomical and functional prognosis of this technology are satisfactory. Therefore, the above issues of IMH are reviewed and commented.

Key words: Idiopathic macular hole, Vitrectomy, Internal limiting membrane, Closure, Visual function