Spontaneous Closure of Simultaneous Idiopathic Macular Holes Documented by Spectral-Domain Optical Coherence Tomography

Abstract

Purpose: To report a case of spontaneous closure of simultaneous full-thickness macular hole.Methods: Case report and literature review.Results: A 67-year-old woman with small-diameter simultaneous macular holes was observed for a period of 5 months, and progression was documented with spectral-domain optical coherence tomography. Closure of right full-thickness macular hole was evidenced by 1 month and left full-thickness macular hole by 5 months. Conclusion:This case demonstrates possible spontaneous resolution of a condition that is usually treated surgically. A period of observation with serial imaging studies may be advised in cases of small macular holes.

Characteristics and Risk Factors for Spontaneous Closure of Idiopathic Full-Thickness Macular Hole

“…It is widely believed that spontaneous release of the vitreomacular traction (VMT) may account for the closure of IMHs [ 21 ], which is also the theory of vitrectomy surgery, since many MHs closed after the relieve of VMT [ 5 , 6 , 8 – 10 ]. Indeed, in our review data, more than half of the IMHs were in stage II, and most VMT relieve during their spontaneous closure of IMHs.…”

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

“…When it occurs, it is typically noted within 1–6 months of onset. 10 , 11 , 12 Previously, the pathophysiology behind this process has been attributed to the formation of bridging intraretinal tissue. 12 Closure is also more likely when the breaks are small, with an aperture size of less than 250 μm.…”

“… 12 Closure is also more likely when the breaks are small, with an aperture size of less than 250 μm. 1 , 10 , 11 Moreover, a literature search failed to identify cases of spontaneous closure following pars plana vitrectomy with ILM peeling. In our case, we not only describe a chronic large hole, but one that closed two years after failed surgical intervention.…”

“…Spontaneous closure of stage 4 idiopathic full thickness macular holes are unusual events. When it occurs, it is typically noted within 1–6 months of onset 10, 11, 12. Previously, the pathophysiology behind this process has been attributed to the formation of bridging intraretinal tissue 12 .…”

“…Previously, the pathophysiology behind this process has been attributed to the formation of bridging intraretinal tissue 12 . Closure is also more likely when the breaks are small, with an aperture size of less than 250 μm 1 , 10 , 11 . Moreover, a literature search failed to identify cases of spontaneous closure following pars plana vitrectomy with ILM peeling.…”