Journal List > J Korean Ophthalmol Soc > v.54(10) > 1009520

Lee, Lee, Yoon, and Kim: A Case of Spontaneous Closure of Macular Hole in a Previously Vitrectomized Eye

Abstract

Purpose

To report a case of spontaneous closure of a macular hole in a previously vitrectomized eye.

Case summary

A 71-year-old female had undergone vitrectomy on the left eye due to a secondary epiretinal membrane with vitreous opacity caused by vasculitis. After the procedure, while the patient was still on medication for the recurrent inflammation of the anterior and posterior segment of the vitreous, a macular hole was found after fundus examinations. Visual acuity of her left eye was 0.125 and ocular coherence tomography (OCT) confirmed a full thickness macular hole with a perifoveal cyst. We recommended vitrectomy, internal limiting membrane peeling, and intravitreal gas injection, but the patient refused further intervention due to her poor general condition. After 2 weeks, resolution of the perifoveal cyst with the macular hole was observed. After 13 weeks, OCT revealed the complete closure of the macular hole with normal foveal depression and the patient regained 0.4 visual acuity.

Conclusions

Spontaneous closure of macular hole is a rare phenomenon in vitrectomized eyes, but a small macular hole with inflammation may close spontaneously without additional intervention. Therefore, observation should be considered rather than hasty surgical intervention. Apparently, the spontaneous closure of a macular hole is due to degenerative processes such as development of macular edema and natural recovery.

References

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Figure 1.
Optical coherence tomography (OCT) showing no abnormal finding 6 weeks after vitrectomy.
jkos-54-1626f1.tif
Figure 2.
Fundus photograph and optical coherence tomography (OCT) confirming the development and the spontaneous closure of a macular hole (MH) in a previously vitrectomized eye. (A) Color fundus photograph of the left eye demonstrating a MH. (B) OCT showing the initial full thickness MH with perifoveal cyst. (C) OCT taken 2 weeks after presentation of MH showing resolution of perifoveal cyst with decreased size of hole. (D) The MH closed spontaneously with a small residual foveal detachment 7 weeks after it developed. (E) Color fundus photograph showing a closure of MH after 13 weeks. (F) OCT performed 13 weeks later showed that the MH had spontaneously closed with normal foveal depression.
jkos-54-1626f2.tif
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