Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report.


Journal

BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802

Informations de publication

Date de publication:
17 Mar 2020
Historique:
received: 25 11 2019
accepted: 04 03 2020
entrez: 19 3 2020
pubmed: 19 3 2020
medline: 29 1 2021
Statut: epublish

Résumé

Macular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure. A 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later. Dynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.

Sections du résumé

BACKGROUND BACKGROUND
Macular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure.
CASE PRESENTATION METHODS
A 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later.
CONCLUSION CONCLUSIONS
Dynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.

Identifiants

pubmed: 32183733
doi: 10.1186/s12886-020-01370-8
pii: 10.1186/s12886-020-01370-8
pmc: PMC7079491
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

108

Subventions

Organisme : Japan Society for the Promotion of Science
ID : KAKENHI grant number: 17K11430

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Auteurs

Minami Chino (M)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Yuji Yoshikawa (Y)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Junji Kanno (J)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Takamitsu Nagashima (T)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Kamishirane Hospital, 2-65-1, Kamishirane, Yokohama, Kanagawa, 241-0002, Japan.

Yu Sakaki (Y)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Takeshi Katsumoto (T)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Masayuki Shibuya (M)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Takuhei Shoji (T)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Jun Makita (J)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.

Kei Shinoda (K)

Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan. shinodak@med.teikyo-u.ac.jp.

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Classifications MeSH