Spontaneous closure of full thickness macular hole in the presence of an epiretinal membrane in a vitrectomised eye: A case report.

Rehman Siddiqui,Muhammad Umar Fawad Muhammad Umar Fawad,Nida Ahsan Nida Ahsan

doi:10.47391/jpma.04-642

Abstract

We report the case of a spontaneous closure of full thickness macular hole (FTMH) in the presence of an epiretinal membrane (ERM) in a previously vitrectomised eye. The patient had undergone vitrectomy for rhegmatogenous retinal detachment and developed an ERM two weeks after the surgery, which converted into a FTMH after one week. Eight months after the vitrectomy, spontaneous closure of FTMH was observed with an improvement in best-corrected visual acuity (BCVA) from 20/200 to 20/40. The patient was followed up for four years, and the FTMH remained closed. Spontaneous closure of FTMH is possible even in the presence of an ERM. Follow-up examination with optical coherence tomography (OCT) may be considered before surgery for FTMH, particularly if the surgery is scheduled a few weeks later.

Highlights

Full thickness macular hole (FTMH) is characterised by a complete thickness anatomic defect at the fovea, leading to decreased visual acuity, metamorphopsia, and central scotoma.[1]
FTMH which developed after vitrectomy can close spontaneously.[11]
We report a case of post vitrectomy FTMH, as evidenced by Spectral Domain Optical Coherence Tomography (SDOCT), that closed spontaneously in spite of an associated epiretinal membrane (ERM)

Summary

Introduction

Full thickness macular hole (FTMH) is characterised by a complete thickness anatomic defect at the fovea, leading to decreased visual acuity, metamorphopsia, and central scotoma.[1]. We report a case of post vitrectomy FTMH, as evidenced by Spectral Domain Optical Coherence Tomography (SDOCT), that closed spontaneously in spite of an associated ERM. Such a case has been reported for the first time in Pakistan. Spectral domain OCTs were performed at each visit which showed shrinkage of the macular hole from the first month onwards, and complete resolution of FTMH at the last visit two-and-a-half years after initial presentation. Consent was taken from the patient for the publication of the report

Discussion

Conclusion