Case Of Full-thickness Macular Hole Research Articles

Spontaneous closure of full-thickness macular hole after pars plana vitrectomy for retinal detachment: evidence of ellipsoid zone restoration.

To describe a case of full-thickness macular hole (FTMH) occurred after pars plana vitrectomy (PPV) for a macula-sparing rhegmatogenous retinal detachment (RRD), which showed a spontaneous closure associated with outer retinal layers restoration. Case report. A pseudophakic 69-year-old man underwent PPV for a macula-sparing superior RRD in the right eye (RE). Best corrected visual acuity (BCVA) was 20/20 before surgery. Three weeks after treatment the patient complained about visual impairment, and a FTMH was detected at fundus examination as well as confirmed by optical coherence tomography (OCT) scan. The patient was scheduled for a repeated surgery, but FTMH spontaneously closed eighteen days after its occurrence as demonstrated at OCT showing only a point break of the ellipsoid zone (EZ) and Verhoeff membrane. The subsequent macular OCT scan showed a point-like irregularity at the Verhoeff membrane and regeneration of EZ, associated with a progressive improvement in BCVA. Forty-days after the FTMH occurrence, all the retinal layers were completely restored with a complete clinical recovery. FTMH formation and closure after macula-sparing RRD repair is a rare event that could be characterized by spontaneous and gradual anatomical restoration of the EZ associated with visual acuity improvement, underlying the retinal physiology recovery.

A Case of Full-thickness Macular Hole Formation Secondary to Laser Retinopexy

Purpose: To report a case of full-thickness macular hole (FTMH) formation secondary to demarcation laser retinopexy in a retinal break with localized retinal detachment patient.Case summary: A 59-year-old male visited our clinic with ocular discomfort in both eyes. Uncorrected visual acuity (UCVA) was 0.63 in right eye. Large retinal break in 1:30 o/c, localized retinal detachment and laser marking scars all around the right eye were found in fundoscopic exam. Posterior-vitreous detachment or vitreomacular traction was not observed in optical coherence tomography (OCT). Demarcation laser retinopexy was performed around the margin of retinal detachment and peripheral degenerative lesions. Three months after demarcation laser retinopexy, UCVA in right eye of the patient was decreased to 0.16 and full thickness macular hole was observed on OCT examination. Pars planar vitrectomy, internal limiting membrane peeling, and SF6 gas tamponade were performed in the right eye. One month after the surgery, closure of FTMH was observed. Three months after surgery, there were no recurrence of FTMH in the right eye.Conclusions: Demarcation laser photocoagulation of localized retinal detachments may predispose to FTMH formation. Even though it can be occurred rarely, follow-up check-up is necessary in consideration of the possibility of FTMH, which can cause serious visual loss.

Closure of Full-Thickness Macular Holes Associated with Macular Edema with Medical Therapy

Purpose: The purpose of this study was to report the closure of macular hole without surgery in 7 cases using medical therapies. Methods: The retrospective review of 7 cases of full-thickness macular holes, which closed after medical therapy without surgery. Results: Seven eyes of 7 patients developed full-thickness macular holes, which initially closed on medical therapy without surgery. Six patients were kept on maintenance therapy; 1 recurred and 5 did not develop recurrence. One patient was taken off of maintenance therapy and later developed recurrent macular hole requiring macular hole surgery. Conclusions: Medical therapy to decrease macular edema may facilitate macular hole closure and should be considered, especially for small macular holes with significant edema. Reopening of macular holes may occur after stopping topical maintenance therapy for macular edema, which occurred at 10 weeks and 9 months after maintenance therapy was discontinued or markedly tapered.

Full-Thickness Macular Hole after Lamellar Macular Hole Surgery: A Case Report

To describe a case of full-thickness macular hole (FTMH) after vitrectomy for lamellar hole (LH). Case report. The authors report a patient with progressive visual loss secondary to LH who developed FTMH following a vitrectomy repair. The postoperative findings as well as the clinical course after the second surgical approach are described. Surgeons should be aware of this complication following LH surgical approach.

Full-Thickness Macular Hole Formation Associated with Central Serous Chorioretinopathy

To report a case of full-thickness macular hole (FTMH) formation associated with central serous retinopathy (CSC). A 63-year-old woman with history of CSC diagnosed 8 years ago presented with vision loss. Clinical examination and optical coherence tomography found FTMH. Seven months following successful surgical repair of the macular hole, the patient presented with decreased vision, and was found to have CSC with closed macular hole. Based on the hydration theory of macular hole formation, CSC and the associated retinal pigment epithelium and choriocapillaris dysfunctions may promote the progression of FTMH.

Full-Thickness Macular Hole after Intravitreal Injection of Ranibizumab in a Patient with Retinal Pigment Epithelium Detachment and Tear

To report a case of full-thickness macular hole (FTMH) after intravitreal injection of ranibizumab in a patient with retinal pigment epithelium detachment (PED) and tear. A 67-year-old woman with PED and retinal pigment epithelium (RPE) tear due to age-related macular degeneration was studied by biomicroscopy, fluorescein and indocyanine green angiography, and optical coherence tomography and was treated with intravitreal ranibizumab. The patient developed a FTMH that was observed 1 month after the ranibizumab injection. Intravitreal ranibizumab may create focal sites of tractional forces on the retinal surface while contraction of the choroidal neovascular membrane may also place forces on the RPE and outer retina. Both actions may have as a result contraction and tearing of the retina leading to the formation of a FTMH.

Secondary Vitrectomy for the Treatment of Macular Holes Occurring After Vitrectomy

Tangential foveal traction by the posterior vitreous cortex is regarded as the main cause of full-thickness macular holes. This report documents two cases of full-thickness macular holes that developed after vitrectomy for other diseases in the apparent absence of the cortical vitreous traction. Autologous serum with pars plana vitrectomy was used to treat these cases. Anatomic closure of the holes was achieved. Macular holes developing after vitrectomy may have an etiology other than tangential vitreous traction, and secondary vitrectomy is useful in treating such holes.