Intravitreal gas of little value in early macular hole

Intravitreal expansile gas is not effective in most cases with early macular hole, according to a prospective study involving 122 patients. The patients in the study all had early, stage 2 macular holes and underwent intravitreal injection of perfluoropropane 0.2ml followed by five days' facedown positioning. The study's investigators found that only three cases (25 per cent) had hole closure with vision improvement, and of those, one developed rhegmatogenous retinal detachment (RRD) and hole re-opening. Another case with persistent hole also developed RRD. In contrast, in seven of the nine cases without hole closure and the one where the hole re-opened had vitrectomy, all had hole closure and vision improvement.

(Chen et al, Ophthalmologica 2012 DOI: 10.1159/000337840.)