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Spontaneous macular hole closure possible after vitrectomy

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In most cases, after vitrectomy anteroposterior vitreofoveal traction associated with macular hole formation does not apply. However, tensile and degenerative forces may lead to hole remodeling, according to a case study.

Wayne R. Lo, MD, and G. Baker Hubbard, MD, described the case of a 69-year-old woman who had a vitrectomy for vitreous hemorrhage seven years earlier. She presented with decreased visual acuity and a macular hole that spontaneously resolved within 4 months. One year after that, the hole re-opened. Visual acuity returned after an internal limiting membrane peel.

Initially, optical coherence tomography showed a macular hole with perifoveal cystoid degeneration and bridging elements. At follow-up visits, OCT showed resolution of the cystoid degeneration.

The case report is published in the May issue of American Journal of Ophthalmology.