Título / Title

AN UNUSUAL SPONTANEOUS CLOSURE OF A MACULAR HOLE

Introdução / Purpose

We report the case of a 56-year-old woman who presented to our outpatient clinic for examination.

Material e Método / Methods

Case report about a spontaneous closure of a macular hole.

Resultados / Results

A 56-year-old female patient presented a complaint of low visual acuity that had started 2 months ago in the right eye and, 2 days ago, in the left eye. On macular OCT examination (Spectralis TM), the patient had a full-thickness macular hole, with floating operculum and complete posterior hyaloid detachment in both eyes (Figure 1).
The patient underwent pars-plana vitrectomy surgery associated inner limiting membrane peeling and injection of C3F8 gas in the right eye, evolving with complete postoperative anatomical recovery. She has being regularly followed up with bilateral macular OCT exams. During the evaluation of the 14th postoperative day, a complete anatomical recovery of the left eye macula was observed, despite the expectant management so far (Figure 2).
She denied any personal or family history, clinical or retinal surgery. Pseudophakic for more than 5 years, presented HM visual acuity in RE and 20/200 in LE, on admission. Currently evolving with VA of 20/200 (still with gas in the right vitreous cavity) and maintains 20/200 in LE. Fundoscopy shows an excellent postoperative aspect in the RE, with slightly altered macular brightness in the LE.

Discussão e Conclusões / Conclusion

Spontaneous closure of a full-thickness macula is a rare phenomenon, probably justified by spontaneous posterior vitreous detachment. In the case described, there was total PVD, which makes the case so relevant.
The discussion above suggests that the full investigation of the case is extremely necessary, such as the discarding of differential diagnoses.

Palavras Chave

Macular Hole; Retinal Perforations; Optical Coherence Tomography

Area

CLINICAL RETINA