Idiopathic macular hole with extensive subretinal fluid: clinical and optical coherence tomography features before and after surgery

PURPOSE: To report clinical and optical coherence tomography (OCT) features in patients with idiopathic macular hole and extensive subretinal fluid (extending at least 1 disk diameter from the center of the hole). DESIGN: Retrospective, consecutive, noncomparative case series. METHODS: The case records of two patients with idiopathic macular holes with extensive subretinal fluid were reviewed. RESULTS: Both patients presented with reduced visual acuity (20/200 and 20/400). OCT demonstrated attachment of the posterior hyaloid to the inner retina, a full-thickness macular hole, cystoid macular edema (CME), and extensive subretinal fluid. After surgery, both patients achieved macular hole closure and improvement in visual acuity (20/60 and 20/30). Postoperatively, OCT showed a normal foveal contour, complete hole closure, and resolution of the CME and subretinal fluid. CONCLUSIONS: In patients with macular hole and extensive subretinal fluid, improved visual acuity and hole closure can be achieved. Preoperative OCT in these patients demonstrates vitreoretinal interface abnormalities, CME, and extensive subretinal fluid. These changes resolve postoperatively.