Bruè C, Rossiello I, Guidotti J M, Mariotti C
Ophthalmology, Department of Neuroscience, Polytechnic University of Marche, Ancona, Italy.
Case Rep Ophthalmol Med. 2014;2014:182892. doi: 10.1155/2014/182892. Epub 2014 Mar 5.
Purpose. Myopic macular holes can be difficult to close with surgery and are frequently associated with retinal detachment. We report on a case of a macular hole in a severely myopic eye that underwent spontaneous closure. Methods. An observational case study. Results. A 55-year-old female was referred to Ophthalmology for a central scotoma and metamorphopsia in the right eye. Visual acuity was 1/20 in both eyes. Fundus examination showed loss of the foveal depression, with a small yellow ring in the center of the fovea in the right eye, and a tilted optic disc and peripapillary staphyloma bilaterally. Spectral domain optical coherence tomography (SD-OCT) revealed a fully developed macular hole with a rim of thickened and slightly elevated retina in the right eye. The patient refused surgery. After 4 years of follow-up, her visual acuity improved to 20/40 in the right eye, and SD-OCT revealed spontaneous sealing of the macular hole without bare retinal pigment epithelium. Conclusions. Myopic macular holes represent a challenge regarding their management, and the prognosis is often poor.
目的。高度近视性黄斑裂孔手术封闭难度较大，且常伴有视网膜脱离。我们报告一例高度近视眼中黄斑裂孔自发闭合的病例。方法。一项观察性病例研究。结果。一名55岁女性因右眼中心暗点和视物变形被转诊至眼科。双眼视力均为20分之1。眼底检查显示右眼黄斑中心凹变平，黄斑中心有一小的黄色环，双眼视盘倾斜及视盘周围葡萄肿。频域光学相干断层扫描（SD - OCT）显示右眼有一个完全形成的黄斑裂孔，伴有视网膜增厚及轻度隆起的边缘。患者拒绝手术。经过4年随访，其右眼视力提高到20/40，SD - OCT显示黄斑裂孔自发封闭，无裸露的视网膜色素上皮。结论。高度近视性黄斑裂孔的治疗是一项挑战，预后通常较差。
