Spontaneous Closure Of Macular Hole Research Articles

Spontaneous closure of macular hole following the development of raised multilobulated macular lesion

Spontaneous closure of stage 3 and 4 full-thickness macular holes (FTMHs) are unusual events. We present a case report of a patient with an idiopathic FTMH that closed spontaneously subsequent to the development of a raised macular lesion provisionally diagnosed as polypoidal choroidal vasculopathy and discuss the possible mechanisms leading to the closure.

Delayed Spontaneous Closure of a Full Thickness Myopic Macular Hole with Good Visual Recovery

Purpose: To present the longitudinal progression of a myopic macular hole with eventual closure and excellent visual recovery over a decade after initial full-thickness hole formation. Methods: The patient was monitored using time-domain and spectral-domain optical coherence tomography images over 16 years. Results: A 68-year-old man with high myopia was referred for surgical evaluation of a full-thickness macular hole and retinal detachment of his left eye, which were repaired. At initial presentation, the fellow eye demonstrated a lamellar hole, which eventually also progressed to become a full-thickness macular hole. The patient subsequently declined surgery and was observed semiannually over the course of 16 years. At 10 years following initial injury, the full-thickness macular hole closed spontaneously. The visual recovery was excellent with an acuity of 20/25. Conclusion: Although surgical intervention remains the mainstay of treatment for macular holes, patients who are not surgical candidates may still have good visual and anatomic outcomes even long after initial hole formation. Lamellar hole epiretinal proliferation material is frequently seen in myopic full-thickness macular holes and may be associated with eventual delayed hole closure due to their slow progression.

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.

Unique Optical Coherence Tomography Imaging in Spontaneous Closure of Full Thickness Macular Hole Post Laser Photocoagulation

Purpose: To study events in spontaneous full thickness macular hole (FTMH) closure following laser photocoagulation (LP). Methods: Retrospective case study of a patient of spontaneous FTMH closure documented by SD-OCT following laser. Results: A 51-year-old lady presented with FTMH and a subclinical retinal detachment (RD) in her right eye. LP for subclinical RD was done and surgery for FTMH was advised. On day of surgery, repeat SD-OCT showed spontaneous closure of FTMH with an outer retinal defect, following which surgery was abandoned. Conclusion: Spontaneous PVD induction relieves antero-posterior traction and Inner limiting membrane (ILM) micro breaks relieves tangential traction, which can result in spontaneous closure of FTMH.

Spontaneous closure of full-thickness macular hole after intravitreal brolucizumab injection for neovascular age-related macular degeneration

Spontaneous closure of full-thickness macular hole after intravitreal brolucizumab injection for neovascular age-related macular degeneration

Spontaneous closure of a traumatic macular hole: The fastest yet?

Spontaneous closure of a traumatic macular hole: The fastest yet?

Spontaneous closure of a chronic full-thickness idiopathic macular hole after Irvine-Gass syndrome resolution

BackgroundFull-thickness idiopathic macular hole (IMH) usually causes serious visual deformities and visual acuity loss. Pseudophakic cystic macular edema, also known as Irvine-Gass syndrome, is another entity that causes visual disturbances, and occurs mainly after cataract extraction. We present a case report of a patient that was diagnosed with a full-thickness macular hole that spontaneously closed after the resolution of an Irvine-Gass syndrome, which occurred after an uneventful cataract extraction.Case presentationA 75 years-old female presented with the complaints of decreased visual acuity and color contrast sensitivity on both eyes (OU) and central visual field deformations on her left eye (LE). She was diagnosed with a full-thickness IMH on her LE, and cataract on OU. After an uneventful cataract extraction via phacoemulsification, she developed an Irvine-Gass syndrome at her LE, which was treated topically. The IMH closed spontaneously after the resolution of the Irvine-Gass syndrome, and the patient is being followed with no further complaints.ConclusionThe exact mechanism for spontaneous closure of full-thickness idiopathic macular holes is still not completely understood. In this case, we hypothesize that the coalesced intraretinal cysts caused by the Irvine-Gass syndrome formed a bridge-like structure connecting the inner walls of the macular hole, thus connecting the remnants of the Muller cells which enabled the full recovery of the normal foveal structure.

Spontaneous closure of macular hole after central retinal vein occlusion

Spontaneous closure of macular hole after central retinal vein occlusion

Spontaneous closure of degenerative lamellar macular hole with epiretinal membrane proliferation

BackgroundTo describe the spontaneous closure of a degenerative lamellar macular hole with epiretinal proliferation (LHEP) as documented with tracked spectral domain optical coherence tomography (SD-OCT).Case presentationA 54-years-old diabetic female patient presented with progressive vision loss in the left eye. SD-OCT illustrated LHEP associated with cystic fluid in the outer nuclear layer. Sequentially tracked SD-OCT showed progressive closure of the degenerative lamellar macular hole and resolution of the CME over almost 4 years, in the absence of any surgical intervention.Discussion/conclusionLHEP may represent a specialized form of degenerative epiretinal membrane associated with Muller cell activation. Spontaneous degenerative LMH closure may rarely occur with these lesion types, in the absence of surgical intervention, possibly due to Muller cell proliferation preceded by PVD.

Spontaneous Closure of an Idiopathic Full-Thickness Macular Hole: A Literature Review.

This work reviews the literature regarding spontaneous closure of idiopathic full-thickness macular holes (FTMHs). Literature on patients with spontaneous idiopathic FTMH closure was reviewed via Ovid MEDLINE, EMBASE, and PubMed through July 16, 2020. A total of 27 of 66 identified articles were included. A total of 68 eyes had spontaneous closure. Of the patients, 62.7% were women and the average age was 67.5 years. Visual acuity improved from Snellen 20/78 to 20/33 post closure. The average hole diameter was 176.8 μm; the largest was 350 μm. Most were stage 2 according to Gass and of small size according to International Vitreomacular Traction Study Group (IVTS) staging. The predominant classification system in recent literature is IVTS staging. The average optical coherence tomography-observed closure time was 4.5 months. On review, reported spontaneous closure rates of all idiopathic FTMH range from 3% to 15%, and no demographic subgroups are more likely to have closure. Holes ≤250 µm have higher closure rates (22.2%) than those in the range of >250 to 400 µm (13.3%) and ≥400 µm (0%). Closure is associated with favorable visual outcomes, and retinal bridging via glial cells is likely critical to closure. These determinations were based on limited numbers; prospective studies are needed to further ascertain rate, mechanism, and characteristics. IVTS staging provides reliable reporting and insight into whether FTMH can be observed before surgery.

Spontaneous Closure of Full-Thickness Macular Holes

Purpose: To describe retinal morphology and vision recovery after spontaneous closure of full-thickness macular hole (FTMH). Materials and Methods: Retrospective, observational study. From a database containing 750 FTMH, we included 23 cases. All patients had a complete ophthalmic examination. Swept-source optical coherence tomography angiography was performed. Results: Prior to spontaneous closure in 11 women and 12 men (mean age 67 years), the mean minimum FTMH diameter was 201 μm, and mean base FTMH diameter was 638 μm. Visual acuity improved from 0.29 Snellen to 0.47 Snellen (p = 0.001) after 6 months and showed no further improvement. Spontaneous closure of FTMH was associated with vitreous detachment in less than half of the cases. Irregularities in the deep vascular layer and hyporeflective areas in the choriocapillaris were noted. Discussion: Equal sex distribution of spontaneous closures (1:1) differs from the high prevalence of females seen in the literature. Complete visual recovery is uncommon in cases of spontaneous closure of FTMH. It might be explained by prolonged defects of the choriocapillaris layer. These findings, along with the evolution of the various morphologies reported in the study, could possibly suggest that delaying vitrectomy while hoping for spontaneous closure might not be justified.

Macular holes following vitrectomy for rhegmatogenous retinal detachment: epiretinal proliferation and spontaneous closure of macular holes.

To describe the characteristics and management of full-thickness macular holes (MHs) that develop after pars plana vitrectomy for rhegmatogenous retinal detachment (RD). Retrospective, interventional, consecutive case series. Patients who developed secondary full-thickness MHs after prior pars plana vitrectomy for RD over a 6-year period were included. The main outcome measures included optical coherence tomography (OCT) findings and the clinical course of full-thickness MHs. A total of 11 eyes of 11 consecutive patients were included in the study. The mean age of the patients was 58.8years (range, 47-70years). The median time between RD repair and MH diagnosis was 36months (range, 1month-11years). The fovea was attached to 10 eyes (91%) at the time of RD repair. OCT demonstrated epiretinal proliferation (EP) at the hole margin in 10 eyes (91%). MH spontaneously closed in 7 eyes (63%) but reopened in 5 eyes. A total of 7 eyes (63%) required a vitrectomy to repair the MHs. All MHs were closed at the last follow-up visit. Full-thickness MHs after pars plana vitrectomy for RD have features that are distinct from that of typical idiopathic MH. The presence of EPs is common, and MHs are prone to spontaneous closure and reopening. These findings suggest that EP may be associated with spontaneous hole closure and that long-term follow-up is necessary even if the MHs close spontaneously.

Spontaneous closure of macular hole with conversion to type 2 choroidal neovascular membrane in a case of Vogt Koyanagi Harada disease

<br>Macular hole in uveitic pathologies is a rare entity. Spontaneous closure of macular hole with conversion to a type 2 choroidal neovascular membrane has been reported even more sparsely. We present an interesting case of a 51-year-old woman with convalescent stage of Vogt-Koyanagi-Harada disease of 20 years duration, who developed a macular hole along with reactivation of the disease. Immunosuppressive therapy was started to control the ocular inflammation, while the macular hole was observed. One and half years later, there was a repeat episode of inflammation when she presented with a decline in vision in the same eye with a choroidal neovascular complex and spontaneous closure of the macular hole. She received two intravitreal injections of ranibizumab biosimilar under systemic immunosuppressive cover. The CNV was stable and the macular hole remained closed over a 6-month drug free interval from the last injection. This is the first report of spontaneous closure of a macular hole with a concurrent neovascular membrane in a case of VKH.<br>

Spontaneous Closure of Macular Hole Following the Separation of Vitreomacular Traction

Spontaneous Closure of Macular Hole Following the Separation of Vitreomacular Traction

A Case Series: Delayed Spontaneous Macular Hole Closure: Insights into Basic Pathophysiology

A Case Series: Delayed Spontaneous Macular Hole Closure: Insights into Basic Pathophysiology

SPONTANEOUS LAMELLAR MACULAR HOLES CLOSURE.

To report two cases of spontaneous closure of lamellar macular holes with epiretinal proliferation (ERP). Observational cases report. Two patients affected with lamellar macular hole showed progressive and spontaneous closure of the hole associated with ERP development. At presentation, both patients presented with irregular foveal contour, and foveal cavitation with apparent loss of retinal tissue. In both cases, ERP, also called "lamellar hole-associated epiretinal proliferation", was present and increased in size over time. This proliferation progressively developed across the hole with apparent restoration of the foveal contour and preservation of visual acuity. This report describes two cases of lamellar macular hole in which ERP increased over time, resulting in lamellar macular hole closure. Such observations may suggest a spontaneous healing process driven by glial cell proliferation.

Spontaneous full thickness macular hole development and closure in a patient with nucleus dislocation due to hypermature cataract: a case report

Spontaneous posterior capsule rupture with lens-nucleus dislocation is a very rare entity, as is the development and spontaneous closure of a full thickness macular hole (FTMH) after vitrectomy. The occurrence of these two entities in one eye has not been previously described. A 79-year-old woman was referred because of the right eye intermittent pain and progressive visual loss. Best corrected visual acuity (BCVA) with correction for aphakia was 20/20. Intraocular pressure was normal with therapy. The cornea, anterior chamber, and vitreous were clear. Gonioscopy was normal. The capsular bag was clear, with rolled-up anterior and posterior lens capsule, and the nucleus dislocated in the vitreous. As surgery waiting time was prolonged due to administrative problems, the patient’s intraocular pressure (IOP) increased and cystoid macular edema (CME) with lamellar macular hole developed. The patient underwent pars plana vitrectomy with endophacofragmentation and epiretinal membrane peeling. Postoperative optical coherence tomography was normal, BCVA was 20/40, and IOP was normal with topical therapy. One month after surgery, the eye was without signs of inflammation and IOP started rising in spite of maximum therapy. CME reoccurred and progressed to a FTMH, which started closing spontaneously in one month. One year after surgery, IOP normalized and FTMH closed completely. A dislocated crystalline lens in a quiet eye with normal BCVA, which rapidly developed into intractable glaucoma and FTMH, is an unusual finding. The deterioration was followed by spontaneous IOP normalization and macular hole closure. Such unexpected disease course, suggesting a possible autoimmune reaction, has not yet been described.

Spontaneous Closure of Pediatric Traumatic Macular Hole

Spontaneous Closure of Pediatric Traumatic Macular Hole

Spontaneous Formation and Closure of Full-thickness Macular Hole after Intravitreal Injection of Aflibercept in Patient with Polypoidal Choroidal Vasculopathy

Spontaneous Formation and Closure of Full-thickness Macular Hole after Intravitreal Injection of Aflibercept in Patient with Polypoidal Choroidal Vasculopathy

Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report

BackgroundMacular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure.Case presentationA 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later.ConclusionDynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.