Late Closure of a Stage III Idiopathic Macular Hole after Pars Plana Vitrectomy

• Published in: Turk oftalmoloji gazetesi 2015-12, Vol.45 (6), p.274-276
• Main Authors: Afrashi, Filiz, Öztaş, Zafer, Nalçacı, Serhad
• Format: Article
• Language: English
• Subjects: Case Report; Internal medicine; Macular hole; optical coherence tomography; Tomography; Vitrectomy
• ISSN: 2149-8695; 1300-0659; 2147-2661; 2149-8709
• DOI: 10.4274/tjo.33603

A 57-year-old female presented to our hospital with decreased vision in her right eye. Detailed ocular examination was performed, and a macular hole was detected in the right eye. The presence of a full-thickness stage III macular hole was confirmed with optical coherence tomography (OCT) imaging. Pars plana vitrectomy followed by long-acting gas tamponade (C3F8) was performed as treatment. One month after surgery, clinical examination revealed a persistent macular hole, confirmed by an OCT scan. Although the patient was scheduled for reoperation, the surgery was postponed due to personal reasons of the patient. Surprisingly, after five months, a closure pattern with accompanying epiretinal membrane was observed in the macular hole area. The closure of the macular hole was completed without any further intervention 8 months post-surgery. In cases of unclosed macular hole after the first surgery, if a second surgery cannot be performed, follow-up with OCT recommended due to the possibility of spontaneous closure. However, spontaneous closure of a persistent macular hole following PPV is rare, so early diagnosis and surgical repair of unclosed macular holes must remain the primary goal.