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.
BMC Ophthalmol. 2020 Mar 17;20(1):108. doi: 10.1186/s12886-020-01370-8.
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.
黄斑裂孔（MH）是发生在黄斑区的视网膜裂孔，涉及神经视网膜层的部分或完全裂开，通过降低视力（VA）和视觉变形来影响视觉质量。我们描述了一例继发于息肉样脉络膜血管病变（PCV）的黄斑下出血（SMH）相关的 MH，其自发性闭合。
一名 67 岁男性因 SMH 导致右眼 VA 下降。VA 为 20/50，每月玻璃体腔内注射阿柏西普 3 次。SMH 逐渐减少，10 个月后发现外部限制膜穿孔，导致 MH。陈旧性血栓消失，MH 持续 10 个月。23 个月后，出现累及黄斑的浆液性视网膜脱离（SRD），MH 消失。SRD 逐渐消失，黄斑形态恢复。VA 逐渐改善，38 个月后达到 20/20。
在一例罕见的继发性和自发性闭合 MH 病例中，观察到超微结构的动态变化。尽管机制不明，但小直径尺寸和渗出性 PCV 被认为有助于闭合。
