Case Report
Volume 13 Issue 6 - 2022
Macular Hole Self Closure While Awaiting Pre-Operative Clearance
Michael Javaheri1,2*, Angela J Oh3, John O’Fee2 and Pradeep S Prasad3
1Retina Specialists of Beverly Hills, Beverly Hills, California, USA
2Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
3Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
*Corresponding Author: Michael Javaheri, Retina Specialists of Beverly Hills, Beverly Hills, California, USA.
Received: April 30, 2022; Published: May 26, 2022




Abstract

Purpose: To describe an atypical presentation of a patient with a Stage 2 full-thickness macular hole (FTMH) who exhibited spontaneous resolution while awaiting pre-operative clearance.

Methods: Complete ophthalmic examination including dilated fundus examination and spectral domain optical coherence tomography (SD-OCT).

Results: A 69-year-old Caucasian female with a history of vitreomacular traction (VMT) presented with a two-week history of visual loss in the right eye. Visual acuity, with correction, measured 20/200 in the right eye. Examination revealed a partial posterior vitreous detachment and a Stage 2 FTMH. SD-OCT testing confirmed a Stage 2 FTMH with VMT. Pars plana vitrectomy without internal limiting membrane peeling was planned and the patient sent for preoperative clearance where she was diagnosed with atrial fibrillation and wanted to delay surgery. Two months later, the patient returned for follow up with a visual acuity of 20/80, a closed macular hole, and an incomplete PVD in her right eye. Four months later, the patient exhibited a completely closed FTMH with a visual acuity of 20/30.

Conclusions and Importance: Spontaneous resolution of full-thickness macular holes (Stage 2-4) is a rare event, occurring in less than 4% of affected eyes. We describe a patient with a Stage 2 full-thickness macular hole who exhibited spontaneous resolution while awaiting pre-operative clearance due to the resolution of VMT.

Keywords: Macular Hole; Optical Coherence Tomography; Posterior Vitreous Detachment; Vitreomacular Traction

References

  1. Duker JS., et al. “The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole”. Ophthalmology12 (2013): 2611-2619.
  2. Lee J., et al. “Spontaneous closure of a chronic full thickness macular hole after failed surgery”. American Journal of Ophthalmology Case Reports 13 (2018): 59-61.
  3. García Fernández M and Castro Navarro J. “Spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole: a case report”. Journal of Medical Case Reports 6 (2012): 169.
  4. Scassa C., et al. “Spontaneous closure of bilateral full-thickness macular holes without surgery: an eleven-year follow-up”. European Review for Medical and Pharmacological Sciences 6 (2011): 717-720.
  5. Michalewska Z., et al. “Spontaneous closure of stage III and IV idiopathic full-thickness macular holes-a two case report”. Graefe's Archive for Clinical and Experimental Ophthalmology 1 (2008): 99-104.
  6. Schweitzer KD and García R. “Spontaneous closure of a stage III idiopathic macular hole”. Canadian Journal of Ophthalmology 1 (2007): 127-128.
  7. Punjabi OS., et al. “Documentation by spectral domain OCT of spontaneous closure of idiopathic macular holes”. Ophthalmic Surgery, Lasers and Imaging Retina 4 (2007): 330-332.
  8. Kim JW., et al. “Baseline characteristics, natural history, and risk factors to progression in eyes with stage 2 macular holes”. Ophthalmology12 (1995): 1818-1829.
  9. Sugiyama A., et al. “Reappraisal of spontaneous closure rate of idiopathic full-thickness macular holes”. Open Ophthalmology Journal 6 (2012): 73-74.
  10. Akiko Okubo., et al. “Early structural changes during spontaneous closure of idiopathic full-thickness macular hole determined by optical coherence tomography: a case report”. BMC Research Notes 6 (2013): 396.
Citation: Michael Javaheri., et al. “Macular Hole Self Closure While Awaiting Pre-Operative Clearance”. EC Ophthalmology 13.6 (2022): 29-32.

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