Spontaneous closure of a chronic full thickness macular hole after failed surgery

Lee, Jennifer; Nguyen, Vincent Q.; Doss, Mallika; Eller, Andrew W.

doi:10.1016/j.ajoc.2018.12.006

Cited by 6 publications

(3 citation statements)

References 16 publications

(34 reference statements)

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“…On the other hand reports about spontaneous closure of a full-thickness macular hole in patients with CNVM are very rare (5,6). Antero-posterior traction forces that created by vitreous and tangential tractions on the surface of the retina are the most extensively accepted mechanisms regarding the pathogenesis of MH (6). The aims of vitrectomy surgery in MH are to remove these abnormal traction forces at the vitreo-macular interface and to promote glial proliferation.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have been reported about spontenous closure of macular hole (2)(3)(4). On the other hand reports about spontaneous closure of a full-thickness macular hole in patients with CNVM are very rare (5,6). Antero-posterior traction forces that created by vitreous and tangential tractions on the surface of the retina are the most extensively accepted mechanisms regarding the pathogenesis of MH (6).…”

Section: Discussionmentioning

confidence: 99%

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Koroid Neovasküler Membranlı Bir Hastada Maküla Deliğinin Spontan Kapanması

Urfalioglu

Güler

Evgin

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Spontaneous closure of a full thickness macular hole is a rare event and usually surgery is needed. A 71 year-old-woman had been followed with the diagnosis of age related macular degeneration (AMD). Four years ago she had complained with sudden vision drop. Visual acuities were 0.05 and 1.0 in right and in left eyes, respectively. On optical coherence tomography examination full thickness macular hole and dry type AMD were detected in her right eye. During follow up it was determined that dry type AMD had changed to wet form and choroidal neovascular membrane (CNVM) had developed. The macular hole had spontenously closed and visual acuity increased despite active CNVM and epiretinal membrane.Choroidal neovascular membrane may facilitate macular hole closure and observation for spontenous closure before surgery may be an option for patients that have these two combined pathologies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Koroid Neovasküler Membranlı Bir Hastada Maküla Deliğinin Spontan Kapanması

Urfalioglu

Güler

Evgin

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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“…Secondary MH may develop in association with trauma [2], macular edema [3], retinal detachment [4], choroidal neovascularization [5][6][7], or submacular hemorrhage (SMH) [8][9][10]. Spontaneous closure is a rare event [7,[10][11][12][13][14][15][16]. We present a rare case of the development of secondary MH and spontaneous closure of MH associated with SMH due to polypoidal choroidal vasculopathy (PCV).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background: Macular 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 presentation: A 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. Conclusion: Dynamic 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.

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The time course of spontaneous closure of idiopathic full-thickness macular holes

Neubauer,

Gelisken,

Ozturk

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose Spontaneous closure of idiopathic full-thickness macular holes (iFTMH) has been reported regularly. However, little is known about its probability and timeline. Methods In this retrospective study all consecutive patients who presented between August 2008 and August 2019 were screened for the presence of a macular hole and only iFTMHs were included. The primary outcome measure was the spontaneous closure of the iFTMH. Results Of 1256 eyes with macular holes, 338 fulfilled the inclusion criteria. Spontaneous closure of the iFTMH was detected in 31 eyes (9.2%) with a median time of 44 days after diagnosis. Eyes exhibiting spontaneous closure demonstrated a higher baseline best-corrected visual-acuity (BCVA) and smaller iFTMH diameter (p < 0.0001 and p < 0.0001, respectively). The mean BCVA improved from 0.4 logMAR (SD ± 0.21) to 0.29 logMAR (SD ± 0.20) after spontaneous closure (p = 0.031). The iFTMH diameter was positively correlated with the time to spontaneous closure (Pearson-r = 0.37, p = 0.0377). Spontaneously closed iFTMHs reopened in 16% (n = 5) of cases, with a median of 136 days after closure. A logistic regression model showed the hole diameter was associated with spontaneous closure (odds-Ratio 0.97, 95%CI [0.96, 0.98]). The Kaplan–Meier-Curve revealed that approximately 25% of small-iFTMH (n = 124) and 55% of iFTMH with a diameter < 150µm (n = 48) closed spontaneously within two months. Conclusion The established gold-standard for the treatment of iFTMHs is macular surgery. However, the potential for spontaneous closure of small iFTMHs must be acknowledged. Therefore, if surgical treatment is delayed in individual cases, close observation is recommended.

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Spontaneous closure of a chronic full thickness macular hole after failed surgery

Cited by 6 publications

References 16 publications

Koroid Neovasküler Membranlı Bir Hastada Maküla Deliğinin Spontan Kapanması

Koroid Neovasküler Membranlı Bir Hastada Maküla Deliğinin Spontan Kapanması

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

The time course of spontaneous closure of idiopathic full-thickness macular holes

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