Download - Macular Hole F.Fazel:MD
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Macular HoleF.Fazel:MD
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Pathophysiology of MH
Trauma Laser treatment Cystoid macular edema Inflammation Retinal vascular disease Retinal detachment Age-related primary
idiopathic
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Idiopathic MH
Seven decade Predominantly female(67%-91%) Younger age in myopes 1%-25% bilatera
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Pathophysiology
Anteroposterior transvitreal traction????...
Tangential traction of cortical vitreous
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Staging
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Staging
1:impendiing MH(foveal &foveolar detached)
2:small fullthicknes MH)<400M)3:fullthickness MH(>400M)4:Complete PVD
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Signs & symptomsstage 1
Mild Central visual loss &metamorphopsia
Loss of foveal depression Yellow spot or yellow ring 50% resolved spontaneously 50% progress to stage 2
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Signs & sympomsstage 2-3
Full thikness hole Vision loss Annular neurosensory detachment Absolute scotoma((watzke-allen
sign)
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Sign & symptomsstage4
Complete PVD (weiss ring)
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Fluorescein Angiography
Circular transmission defect(stage 2-3-4)
Loss of xanthophyll & RPE atrophy
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OCT
IS GOLD STANDARD IN DIAGNOSIS AND STAGING
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Stage 1
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Stage 2
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Stage 3
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Stage 4
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Management
Stage 1:fallow up Stage 2-4:vitrectomy +gas
injection(90%-100% hole closure)
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