Prognosis of fellow eyes in idiopathic macular hole cases

: We studied contralateral eyes in 62 cases of unilateral idiopathic macular hole to determine their prognoses and risk factors for this disorder. At the initial examination, 11 of 62 eyes (18%) showed a macular cystic lesion, and 18 (29%) showed a yellow spot in the fovea. During a mean follow-up of 39 months, macular holes eventually developed in 6 of the 11 eyes (55%) with macular cystic lesion and in 4 of 18 eyes (22%) with a yellow spot. Macular holes, however, did not develop in eyes with vitreous separation in the fovea or with a normal macula. Moreover, the macular lesion apparently improved in 14 of 29 eyes (48%) with early stage macular holes. These fourteen eyes showed vitreous separation in the fovea at the initial examination or at the follow-up examination. Therefore, eyes with macular cystic lesions and without posterior vitreous separation are at high risk of a macular hole developing, although these eyes have a chance for improvement by spontaneous vitreous separation.