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The spontaneous closure, reopening and the further spontaneous closure of a stage IV full-thickness idiopathic macular hole- a case report

Session Details

Session Title: Quick Fire Free Paper 1

Session Date/Time: Thursday 11/09/2014 | 08:00-10:00

Paper Time: 09:45

Venue: Boulevard D

First Author: : C.De Giacinto ITALY

Co Author(s): :    R. Piermarocchi   D. Minutola   D. Tognetto        

Abstract Details

Purpose:

To report a case of the spontaneous closure, reopening and the further spontaneous closure of a stage IV full-thickness idiopathic macular hole.

Setting:

Observational case report, University Eye Clinic of Trieste.

Methods:

A 77-year-old man presented with decreased vision in his right eye and a history of metamorphopsia over a period of approximately four months. The best-corrected visual acuity (BCVA) was 20/62. He did not report any trauma. Diagnosis was based on funduscopic examination, Spectral Domain Optical Coherence Tomography (SD-OCT) and fluorescein angiography. These tests revealed a stage IV full-thickness idiopathic macular hole and a small epiretinal membrane.

Results:

We performed a one-year follow-up with regular BCVA evaluation, fundus examination and SD-OCT. On the first month after the baseline visit, we observed the spontaneous closure of the macular hole accompanied by an improvement in visual acuity (BCVA: 20/32). In agreement with the patient, we decided to perform clinical evaluation and SD-OCT monthly. Six months later, we noticed a complete spontaneous closure of the hole with a recovery of 20/25 BCVA. Eight months later, the patient was referred again to our hospital with a complaint of decreased vision in his right eye; we reported the spontaneous reopening of the macular hole with a loss of vision (BCVA: 20/50), followed by the new spontaneous closure with a recovery of 20/25 BCVA within two months.

Conclusions:

The spontaneous closure of a full-thickness idiopathic macular hole is an extremely rare event; there are only two reports of the spontaneous reopening of a previously spontaneously closed full-thickness idiopathic macular hole. To the best of our knowledge, there are no papers in the literature describing a spontaneous reopening followed by the spontaneous closure of a full-thickness idiopathic macular hole that initially spontaneously closed.

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