Evolution and Management of a Post-Uveitis Macular Hole

Abstract

The case of a 44-year-old woman who was under treatment for bilateral recurrent anterior uveitis with chronic cystoid macular edema for two and a half years. She presented with an acute visual decline in her left eye, and was found to have a lamellar macular hole in the right eye and a full-thickness macular hole in the left eye. She underwent vitrectomy, internal limiting membrane peeling and perfluoropropane (C(3)F(8)) gas tamponade with simultaneous cataract extraction in the left eye. Her best-corrected visual acuity improved from 4/60 to 6/36 postoperatively, with closure of macular hole. Four months following vitrectomy, she developed cystoid macular edema in the operated eye, with a drop in vision to 6/60. An intravitreal injection of triamcinolone acetonide resulted in recovery of visual acuity 6/24, which was maintained till the last follow-up.

Mesenchymal Stem Cell-Derived Secretome: A Potential Therapeutic Option for Autoimmune and Immune-Mediated Inflammatory Diseases

“…The post-uveitis macular hole is a potentially severe complication [ 121 ]. In a recent pilot study, the efficacy of the intravitreal injection of MSC-Exos following standard pars plana vitrectomy (PPV) in conjunction with inverted internal limiting membrane (ILM) flap technique and ILM peeling was evaluated for the treatment of massive and resistant macular holes [ 122 ].…”

The Anatomical and Clinical Outcome of Conventional Macular Hole Surgery Associated with Serpigenous Choroiditis

“…Ocular inflammation was controlled by systemic corticosteroids before macular hole surgery and there was successful closure of the macular hole with improvement in vision. There are only few reports of closure of the macular hole associated with posterior uveitis, following conventional macular hole surgery with improvement in vision on Medline search [1,4]. Therefore, we would like to report this case.…”

“…In particular fundus auto fluorescence is a non invasive, sensitive imaging technique for detecting damage of the RPE in acute episodes of Serpigenous chroididtis [3]. Long standing cystoid macular edema, inflammatory cellular membrane proliferations, Vitreo-macular traction forces caused by severe recurrent vitritis in combination with the retinochoroidal atrophy are the probable mechanisms of macular hole formation in chronic recurrent ocular inflammatory conditions [4]. Presence of cystoid macular edema, surrounding retinal detachment and tangential vitreous traction establishes rational for surgical treatment of macular holes [5].…”

Spontaneous closure of macular holes secondary to posterior uveitis: case series and a literature review

“…The literature reports 55 cases of macular hole secondary to posterior uveitis (Table 1): 35 Behcet's disease [5-11], 3 idiopathic intermediate uveitis [9], 2 idiopathic posterior uveitis [9], 1 bilateral intermediate uveitis [12], 2 Bartonella henselae [13,14], 2 toxoplasmosis [15,16], 2 Vogt-Koyanagi-Harada [17], 1 cytomegalovirus (CMV) retinitis [9], 1 HLA B27 uveitis [18], 1 bilateral anterior uveitis [19], 1 serpiginous choroiditis [20], 1 fungal endophthalmitis [21], 1 T/natural killer (NK) lymphoma [22], 1 presumed histoplasmosis [23], and 1 immune recovery uveitis in an AIDS patient after CMV retinitis [24]. …”