Idiopathic horseshoe-like macular tear: a case report

Abstract

BackgroundAlthough a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined.ObjectiveTo report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery.Case reportA 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD). Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved.ConclusionWhile cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases.

A human amniotic membrane plug to repair retinal detachment associated with large macular tear

“…; Kubota et al. ). In addition, few cases were described after retinal vein occlusion (Karim‐Zade et al.…”

Development of traumatic bilateral horseshoe-shaped macular tear without vitreous traction: Case report

“…Horseshoe-shaped macular tears are rare, and the size of the tear is usually relatively large at 0.75 to 1.5 DDs. [ 1 2 3 4 ] It has been reported that severe traction by the vitreous on the retina leads to the macular tears in cases of branch retinal vein occlusion[ 3 ] and idiopathic[ 4 ] horseshoe-shaped macular tears. Karaca et al .…”

“…Several cases of an unusual tear called a “horseshoe-shaped macular tear“ have been reported. [ 1 2 3 4 ] These tears can be caused by blunt trauma that leads to a sudden traction by the vitreous on the retina leading to the macular tear. We report a case that had horseshoe-shaped macular tears bilaterally that developed without vitreous traction.…”

Vitreous haemorrhage caused by unusual giant macular tear: a case report

“…The primary causes of vitreous haemorrhage include diabetic retinopathy, branch retinal vein occlusion (BRVO), trauma, retinal tear, rhegmatogenous retinal detachment, and posterior vitreous detachment. 1 – 3 However, vitreous haemorrhage is rarely caused by a macular tear. To the best of our knowledge, only a few cases of macular tears have been reported in the literature.…”

“…To the best of our knowledge, only a few cases of macular tears have been reported in the literature. 1 – 3 To facilitate better clinical understanding of macular tears, this report describes the details and corresponding etiological analysis of a patient with a giant retinal tear in the fovea.…”