Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography

The optical coherence tomography (OCT) and clinical characteristics of traumatic macular holes (TMHs) can be compared to those of idiopathic macular holes (IMHs) to gain insights into the pathogenesis of both. The demographic data and visual acuity of 73 consecutive patients with unilateral, full-thickness TMHs and 182 consecutive patients with idiopathic IMHs were recorded. All patients with TMH and 60 patients with IMH underwent OCT scanning and quantitative measurements. The apical and basal diameters and marginal retinal thicknesses were recorded for each hole. The hole areas and eccentricities were calculated. These parameters were compared between the two types of macular holes, and correlated with visual acuity. Compared to IMHs, TMHs were generally thinner, larger at the base, less circular, and were associated with worse vision. Vitreous detachment was more commonly associated with IMHs than TMHs. Both IMHs and TMHs were wider horizontally than vertically. Visual acuity was negatively correlated with the size of IMHs, but not with any tomographic parameters in TMHs. The tomographic and clinical findings associated with TMHs and IMHs provide useful insights into the pathogenesis of these two types of macular holes.