Departemnt of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India.
Ophthalmology, Abergele Hospital, Abergele, UK
BMJ Case Rep. 2021 Aug 10;14(8):e243551. doi: 10.1136/bcr-2021-243551.
We describe a case of spontaneous conversion from type 2 macular hole (MH) closure to type 1 closure following MH surgery in high myopia. A 42-year-old male patient with myopia was diagnosed with full-thickness MH and localised neurosensory detachment. His best-corrected vision in the right eye was 20/120, N18. He underwent pars plana vitrectomy with internal limiting membrane peeling and silicone oil tamponade. Nine days after surgery, optical coherence tomography (OCT) showed type 2 MH closure and presence of epiretinal tissue. At 6 weeks of follow-up, there was spontaneous conversion from type 2 to type 1 closure of MH with a thin epimacular tissue bridging across the fovea and vision improving to 20/80. At 3 months after surgery, silicon oil removal was done. OCT showed a closed type 1 MH and visual acuity of 20/80 at the final visit. Early spontaneous conversion in closure can occur over time, leading to better anatomical and visual outcomes.
我们描述了一例高度近视患者在接受 2 型黄斑裂孔(MH)手术后,自发从 2 型裂孔闭合转变为 1 型裂孔闭合的情况。一名 42 岁男性近视患者,被诊断为全层 MH 和局限性神经感觉脱离。他右眼最佳矫正视力为 20/120,N18。他接受了经睫状体平坦部玻璃体切除术联合内界膜剥除和硅油填充。术后 9 天,光学相干断层扫描(OCT)显示 2 型 MH 闭合,存在视网膜前组织。6 周随访时,MH 自发从 2 型转变为 1 型闭合,黄斑中心凹有一层薄的内界膜组织桥跨过,视力提高至 20/80。术后 3 个月,硅油取出。OCT 显示最终随访时为闭合性 1 型 MH,视力为 20/80。早期的自发闭合转变可以随着时间的推移而发生,从而获得更好的解剖和视觉结果。