García Fernández Miriam, Castro Navarro Joaquín
Department of Opthalmology, Central University Hospital of Asturias, Oviedo, Asturias, Spain.
J Med Case Rep. 2012 Jun 28;6:169. doi: 10.1186/1752-1947-6-169.
Spontaneous closure of traumatic macular holes is described as a common event in the peer-reviewed literature. However, the spontaneous closure of stage III and IV full-thickness idiopathic macular holes has been reported in less than 15 cases in the literature, this being an extremely rare event, with their reopening being even more infrequent. We report a case of a spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole.
A 67-year-old Spanish man was referred to our hospital with a complaint of decreased vision in his right eye and metamorphopsia for approximately 11 months. He did not report any trauma. Diagnosis was based on fundoscopic and optical coherence tomography. They revealed a stage IV full-thickness idiopathic macular hole and a small epiretinal membrane. Three months later the hole spontaneously closed, and two years later we appreciated its reopening as a lamellar macular hole.
The contraction of the epiretinal membrane could have contributed to cystic spaces and their fusion, subsequently, to the formation of a lamellar macular hole. To the best of our knowledge this is the first report in the literature of a spontaneously closed full-thickness idiopathic macular hole with reopening as a partial thickness macular defect.
在同行评审的文献中，创伤性黄斑裂孔的自发闭合被描述为一种常见现象。然而，文献报道的III期和IV期全层特发性黄斑裂孔的自发闭合病例不足15例，这是极为罕见的事件，而其再次开放则更为少见。我们报告一例IV期特发性全层黄斑裂孔自发闭合并后期再次开放形成板层黄斑裂孔的病例。
一名67岁的西班牙男性因右眼视力下降和视物变形约11个月转诊至我院。他未报告有任何外伤史。诊断基于眼底镜检查和光学相干断层扫描。检查发现一个IV期全层特发性黄斑裂孔和一个小的视网膜前膜。三个月后，裂孔自发闭合，两年后我们发现其再次开放形成了一个板层黄斑裂孔。
视网膜前膜的收缩可能导致了囊腔及其融合，随后形成了板层黄斑裂孔。据我们所知，这是文献中首例全层特发性黄斑裂孔自发闭合并再次开放形成部分厚度黄斑缺损的报道。
