New Treatment for Macular holes

Recent approval of Jetrea (Ocriplasmin) to treat symptomatic VMA (Vitreo Macular Adhesion) has opened up a new era in non surgical management of macular holes. Previously only a hospital based surgery was able to reverse the process of macular hole development but now a new drug can be injected into the eye painlessly in the office and within a few weeks the process reverses back to more normal vision levels....  more

FDA Approves ASRS Leader's ArgusŪ II Artificial Retina

On February 14, the FDA approved the Argus II artificial retina developed by ASRS Executive Committee and Board Member Mark S. Humayun, MD, PhD.

This breakthrough technology is the first ever to offer limited vision to patients with late-stage retinitis pigmentosa (RP).

 Second Sight Medical Products (Sylmar, CA) manufactures the Argus II implant, which has 60 electrodes and a tiny camera mounted on eyeglasses to capture images.

 The FDA approved Argus II for adults age 25 years or older with severe to profound RP. About 10,000 to 15,000 of the 100,000 Americans with RP will qualify for Argus II. Up to 4,000 patients a year can be treated with the device.

...  more

Macular degeneration and Aspirin?

Aspirin and Macular degeneration... is there an increase in the wet form of macular degeneration in those patients taking aspirin? The wet form develops quicker than the dry form. It may only be related to the fact that you are more likely to take aspirin if you have medical problems like stroke or heart attacks in the past and these conditions are more commonly associated with wet age related macular degeneration. ...  more

Macular Hole


Macular holes typically occur as a direct result of aging.  In the eye, vitreous gel fills much of the interior and helps keep a round shape.  Small fibers within the vitreous attach it to the retina at the back of the eye.  As individuals age, their vitreous shrinks, pulling the fibers with it away from the retina.  When this pulling takes place, a hole can form on the macula, allowing natural eye fluids to seep through and distort central vision.  Macular holes rarely heal on their own therefore almost all are repaired through a vitrectomy surgery.


Symptoms & Types:

When a macular hole forms, early symptoms include blurriness of one’s central vision, or objects might appear bent or wavy when looking at them straight-on.  As the hole progresses, it may become increasingly difficult to read or perform other day-to-day tasks (driving especially). An Amsler grid eye test will show increasing distortion and a dark spot in the central vision. 



To repair a macular hole surgically, an outpatient procedure called a vitrectomy is performed.  During the procedure, the vitreous gel within the eye and a layer of scar tissue on the macula is removed and a bubble of either gas or silicone oil is placed in the vitreous to float to the back of the eye and keep the hole closed until it can heal. The gas bubble can close the hole in only 4 days of face down positioning but it will open up again in a very large number of patients and they had to have another surgery to close it again. There is a simple relationship: The longer the hole remains closed with the bubble the higher the success rate is and the better the vision becomes. The bubble will be absorbed on average in 6 weeks without further intervention. Being face down for two weeks is currently thought to be ideal for hole closure. For those patients that cannot position due to previous neck or back surgery or problems, then silicone oil can be placed in the eye and positioning is not as critical. Being normal position is possible, however laying on the back for long periods of time with silicone oil in the eye is not good for hole closure or eye pressure and can cause failure of the hole to close. A second surgery 3-6 months later is needed to remove the oil if the hole is closed. If there is a natural lens in the eye (no previous cataract surgery) then is it highly likely that cataract surgery will also be needed in the next 6-12 months. 
New treatment of early macular holes are now possible with the injection of a drug called Jetrea. This is now a clinic procedure that takes only minutes to perform and can stop early holes in about 25 to 50% of cases. It carries a small risk of infection and may still have to have surgery if it does not work. See the blog on this web site. 



Macular holes can sometimes occur as a result of other eye conditions and disorders such as nearsightedness, recent retinal detachment, diabetic retinopathy, epiretinal membranes or trauma to the eye.

Be sure to keep all existing eye conditions under observation by your physician or one of our specialists at East Carolina Retina Consultants in order to identify underlying complications before they begin to interfere with vision and daily activities. Monitoring an amsler grid is helpful to be able to notice when the vision is changing and needs re-examination.