Posters

Spontaneous closure of an idiopathic stage III full-thickness macular hole

Poster Details

First Author: I.Tzamichas GREECE

Co Author(s):    E. Zopounidou   C. Keskini   T. Paschaloglou   P. Kalouda   C. Kampos   G. Sakkias              

Abstract Details



Purpose:

To present a case of spontaneous closure of an idiopathic stage III full-thickness macular hole, without any surgical or pharmacological intervention.

Setting:

Ophthalmology Department, Hippokrateio General Hospital, Thessaloniki, GREECE.

Methods:

The case is presented on the basis of an observational case report. We evaluated data acquired from clinical examination and spectral domain optical coherence tomography (SD-OCT).

Results:

An 81 year old male patient presented to our clinic for a scheduled examination. BCVA was 10/10 in OD and CF in OS. The patient was pseudophakic in the OD while nuclear cataract was present in OS. During fundoscopy a retinal break treated by laser photocoagulation was found in OD, while the OS was difficult to examine due to dense cataract. SD-OCT showed a full-thickness stage III macular hole in OS. Pars plana vitrectomy was scheduled to be performed in 6 months. Until then the patient was examined every 2 months. Partial dehydration of the cysts in the hole margin was noticed in SD-OCT after 2 months while early signs of macular hole closure were noticed 2 months later revealing bridge formation. BCVA was 4/10. At 6-month evaluation progression of the closure of the macular hole with partial restoration of the outer retinal layers and presence of mild subretinal fluid was confirmed by SD-OCT while BCVA was 5/10.

Conclusions:

Stage III idiopathic macular holes require surgical intervention with pars plana vitrectomy. Only 6-7% resolve spontaneously. Prognosis regarding visual acuity and structural restoration is better when macular holes are treated during the first year since diagnosis. Waiting for 6 months until surgery while examining the patient every 2 months is an option in order to observe any structural OCT changes indicating macular hole closure. Also rigorous follow-up is mandatory because these macular holes can eventually reopen.

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