Development of macular pseudoholes - A 36-month period of follow-up

Purpose: To assess the changes in visual acuity and macular sensitivity and the possible evolution into a full-thickness macular hole in patients with macular pseudoholes during a 3-year follow-up period. Methods: Twenty-seven eyes (mean age, 61.0 +/- 8.9 years) with macular pseudoholes were enrolled. They were compared with 16 eyes from 16 age-matched control eyes. In each eye with a macular pseudohole, we assessed the Snellen visual acuity and macular sensitivity by scanning laser ophthalmoscopic central (1-2degrees of the macula, SLO-CM) and paracentral (annular area from 2-7degrees from the macula, SLO-PM) microperimetry at the time of diagnosis (baseline condition) and every 6 months for 3 years. Results: Eyes with macular pseudoholes at baseline had a significant (P < 0.015) reduction in visual acuity, SLO-CM, and SLO-PM when compared with control eyes. After 12 months of follow-up, no changes in VA, SLO-CM, or SLO-PM were observed in eyes with macular pseudoholes with respect to the baseline values. After 36 months of follow-up, further significant (P < 0.05) decreases in visual acuity, SLO-CM, and SLO-PM were observed. One third of eyes with macular pseudoholes showed an evolution into a full-thickness macular hole. In these eyes, the lowest SLO-CM had been observed at the baseline condition. Conclusion: This study suggests that in the 36-month follow-up period in eyes with macular pseudoholes, there is the possibility of a worsening trend, leading to the development of a full-thickness macular hole. A useful role of the functional assessment by SLO-CM and SLO-PM can be suggested for the clinical diagnosis and the follow-up of macular pseudoholes.