Spontaneous closure and reopening of full-thickness macular hole: Two case reports
Chiung-Yi Chiu, Yen-Yi Chen, Jia-Kang Wang
Purpose: To present two cases of full-thickness macular hole (FTMH) with spontaneous closure and reopening. Case reports: The 69-year-old man complained of blurred vision in the right eye. His best corrected visual acuity (BCVA) was 20/800. No significant finding over anterior segment except grade 2 nuclear sclerosis. Fundus examination showed proliferative diabetic retinopathy status post panretinal photocoagulation and macular hole. Optical coherence tomography (OCT) demonstrated a FTMH. The patient underwent outpatient clinic follow up and macular hole spontaneously closure was noted 6 months after first time visit without any surgery. However, OCT revealed no ellipsoid zone recovery and no visual acuity improvement. The second case is a 52-year-old man. He had high myopia with refractive error of -13 diopters before cataract surgery in the left. He complained of blurred vision of left eye for years. Initial BCVA was 20/100 without significant finding over anterior segment except pseudophakia in the left. Fundus examination revealed myopic FTMH with posterior staphyloma in left eye. OCT demonstrated FTMH with epiretinal membrane. No subretinal fluid or retinal detachment was noted. Closed macular hole was noted after pars plana vitrectomy with epiretinal membrane and internal limiting membrane peeling. His BCVA improved to 20/50. However, closed macular hole reopened to FTMH without associated retinal detachment 4 years later. His BCVA decreased to 20/125 without further management. Conclusion: Spontaneous closure rate was uncommon in cases with FTMH. BCVA of the first patient remained unchanged even under Hole closure without ellipsoid zone regeneration demonstrated by OCT. Reopening of the hole is one of the complications after initially successful surgery for FTMH and tend to occur in high myopic eyes.