Spontaneous Closure of a Full-Thickness Macular Hole Associated with Proliferative Diabetic Retinopathy and Persistent Vitreomacular Traction

Rezaeian-Ramsheh

RETINAL Cases &Amp; Brief Reports

et al. 2024

Background: The purpose of this study was to describe a successful closure of macular hole without release of vitreomacular traction after intravitreal perfluoropropane (C3F8) gas injection.Case Presentation: A 54-year-old woman was referred to our clinic with the history of declined vision after a period of distorted vision in her right eye. After dilated fundus examination and performing optical coherence tomography, a V-shaped vitreomacular traction complicated by full-thickness macular hole was diagnosed and she underwent pneumatic vitreolysis using intravitreal C3F8 gas injection. After 12 weeks, her visual acuity was significantly improved and fundus examination and optical coherence tomography revealed that the macular hole was completely resolved despite persisted vitreomacular traction.Conclusion: Intravitreal gas injection would be a promising option to manage idiopathic macular holes not only by releasing the vitreous traction on the macula but also through some not proven or even unknown mechanisms.

Section: Discussionmentioning

confidence: 94%

Closure of Idiopathic Full-Thickness Macular Hole After Intravitreal C3f8 Injection Without Vitreomacular Traction Release: A Case Report and Review of Literature

Rezaeian-Ramsheh

RETINAL Cases &Amp; Brief Reports

et al. 2024

“…Spontaneous closure of full thickness macular hole has been widely reported in other country (Brue et al 2014, Reinherz & Rubin 2016, Scassa et al 2011) but not in Malaysia. As in this case, it is classified as idiopathic macular hole as there is no secondary…”

Section: Discussionmentioning

confidence: 95%

Spontaneous Closure of Large Base Idiopathic Full Thickness Macular Hole

Bastion¹

2018

Spontaneous closure of idiopathic full thickness macular hole is a rare case as it occurs in only 3.5% while awaiting vitrectomy surgery. There are few pathologies associated with it such as vitreomacular traction (VMT) and posterior vitreous detachment. We report a case in a 74-year-old man who presented with right eye painless, progressive blurring of vision with idiopathic stage 4 full thickness macular hole which was confirmed on optical coherence tomography. It closed spontaneously after sometimes while waiting for surgery. It is important to monitor closely for the possibility of spontaneous closure based on the optical coherence tomography findings.

“…An unexplained finding is the spontaneous formation and closure of FTMH in previously vitrectomized eyes [5]. This might be associated with defects in the choroid tissue underlying the fovea.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Closure of Full-Thickness Macular Holes

Nawrocka¹,

Nawrocki²

2021

Ophthalmologica

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.