Topical carbonic anhydrase inhibitors closing bilateral secondary macular holes and a review of literature.

Abstract

To present a rare occurrence of bilateral macular hole secondary to vitrectomy that was successfully treated with topical carbonic anhydrase inhibitors and to review the literature for this phenomenon. Monthly clinical examination and optical coherence tomography (OCT) was conducted before and after eight weeks of topical 2% dorzolamide administered twice a day. A 62-year-old male that had bilateral giant retinal tears which were repaired with vitrectomy subsequently presented with bilateral small macular holes of size 74 and 78 microns. Patient was trialled on 2% topical dorzolamide twice a day and reviewed monthly with OCT scans. Macular hole closure was identified after four weeks of topical treatment. Conclusion: Clinical improvement with conservative measures suggests a potential first line approach to the treatment of macular holes avoiding surgery and its risk profile. We also present a review of literature regarding macular holes treated with topical carbonic anhydrase inhibitors and its mechanism of action in treating macular holes.