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