Clinical pathogenesis of macular holes in patients affected by retinitis pigmentosa

Background. To define the main clinical mechanisms involved in the pathogenesis of macular holes (MH) in patients affected by Retinitis Pigmentosa (RP). Methods. 236 RP subjects were enrolled in this study and ophthalmologically examined according to a standard FIARP (Italian Federation of the RP Associations) protocol. The prevalence of posterior vitreous detachment (PVD) as well as all types of RP-related macular abnormalities - especially vitreoretinal interface alterations (VRIA), cystoid macular edema (CME), "bull's eye maculopathy" (BEM) and MH - was reported; statistical analyses and correlations were assessed by means of Student t test and Pearson X2. Results. VRIA and CME were observed in 26.15% and 9.45% of the cases respectively and resulted significantly associated with MH, since they were constantly present in 22 of the 25 eyes affected by MH (88%) (X2 = 50.4; p < 0.01). In particular, in 9 of these cases (40.9%) MH was correlated to both CME and VRIA, while in 11 (50%) and 2 (9.1%) eyes CME or, VRIA were present separately. A normal biomicroscopic macular appearance, PVD and BEM were found in 26.81%, 6.6% and 21.54% of the cases respectively. Conclusions. Further studies involving a larger number of patients are required to complete these preliminary results. However, the present investigation seem to confirm the data already reported in the literature, i.e. that pathogenesis of MH in RP is strictly correlated to the presence of VRIA, cellophane maculopathy and cystic foveal degeneration with CME.