Macular hole formation in patients with retinitis pigmentosa and prognosis of pars plana vitrectomy.

Abstract

To investigate macular hole (MH) formation in patients with retinitis pigmentosa (RP) and to determine surgical prognosis for these patients. Data for four RP patients with MHs were retrospectively reviewed. Comprehensive ocular examinations, including electroretinography, Goldmann perimetry, color funduscopy, B-scan ultrasonic tomography, and optical coherence tomography (OCT), were performed. All patients underwent par plana vitrectomy followed by peeling of the posterior inner limiting membrane and gas tamponade. Preoperative best-corrected visual acuity ranged from 20/1000 to 20/100. Typical full-thickness MHs were evident by OCT for three patients. Two of these patients had posterior vitreous detachment or vitreoretinal traction; one had cystoid macular edema in the fellow eye. A fourth patient had extensive retinal detachment; ophthalmoscopy revealed a hole in the macular region. After surgery, significant improvement of visual acuity was recorded for three patients; the patient with retinal detachment had no change in visual acuity in the affected eye. OCT showed adequate sealing of the MHs. We report results of a clinical investigation including four RP patients with concomitant MHs. Vitreoretinal surgery is necessary for effective management of MHs in RP.