The effect of laser treatment on macular holes evaluated by a scanning laser tomograph

Purpose. To evaluate the effect of laser treatment on full thickness macular holes and to examine the subsequent topographical changes in the macular surface. Methods. Twelve eyes with full thickness macular holes and visual acuity less than 20/100 who could not undergo vitrectomy, were treated by Argon green laser photocoagulation. The laser burns were placed in a ring around the holes at the elevated rim. The topographic characteristics of the hole and rim, including area, depth of the hole and height of the rim before and after treatment, were evaluated by the Heidelberg Retinal Tomograph (HRT). The findings were compared to a control group of non treated macular holes. The anatomical results were matched against the functional results of visual acuity and threshold sensitivity. Results. Following treatment, a collapse of the elevated rim surrounding the macular hole was noted and measured by HRT. Changes in the hole and the rim area, in the depth of the hole and in threshold sensitivity were also noted. During the follow-up period (6-18 months), visual acuity improved in 6 eyes, deteriorated in 4 eyes and was unchanged in two eyes. Conclusions. Laser photocoagulation can lead to flattening of the elevated rim and improvement of the visual acuity and the threshold sensitivity in selected cases of idiopathic full thickness macular holes.