Spontaneous closure of full-thickness macular hole after pars plana vitrectomy for retinal detachment: evidence of ellipsoid zone restoration.

Abstract

PURPOSE:

To describe a case of full-thickness macular hole (FTMH) occurred after pars plana vitrectomy (PPV) for a macula-sparing rhegmatogenous retinal detachment (RRD), which showed a spontaneous closure associated with outer retinal layers restoration.

METHODS:

Case report.

RESULTS:

A pseudophakic 69-year-old man underwent PPV for a macula-sparing superior RRD in the right eye (RE). Best corrected visual acuity (BCVA) was 20/20 before surgery. Three weeks after treatment the patient complained about visual impairment, and a FTMH was detected at fundus examination as well as confirmed by optical coherence tomography (OCT) scan. The patient was scheduled for a repeated surgery, but FTMH spontaneously closed eighteen days after its occurrence as demonstrated at OCT showing only a point break of the ellipsoid zone (EZ) and Verhoeff membrane. The subsequent macular OCT scan showed a point-like irregularity at the Verhoeff membrane and regeneration of EZ, associated with a progressive improvement in BCVA. Forty-days after the FTMH occurrence, all the retinal layers were completely restored with a complete clinical recovery.

CONCLUSION:

FTMH formation and closure after macula-sparing RRD repair is a rare event that could be characterized by spontaneous and gradual anatomical restoration of the EZ associated with visual acuity improvement, underlying the retinal physiology recovery.

• Authors: Francesco Pellegrini, Federica Fossataro, Claudia Fossataro, Clara Rizzo, Stanislao Rizzo
• Journal: Retinal cases & brief reports (Retin Cases Brief Rep) (Aug 08 2023) ISSN: 1937-1578 [Electronic] United States
• PMID: 37582338 (Publication Type: Journal Article)