Nishikawa Keiichi, Yamashiro Kenji
Department of Ophthalmology, Otsu Red Cross Hospital, Otsu, Japan.
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Am J Ophthalmol Case Rep. 2021 Dec 31;25:101251. doi: 10.1016/j.ajoc.2021.101251. eCollection 2022 Mar.
To report a case of macular hole (MH) closure at seven years after internal limiting membrane (ILM) peeling.
A 66-year-old woman developed a MH in her left eye. Pars plana vitrectomy with ILM peeling and SF6 gas injection followed by face-down position for a week slightly improved the visual acuity from 20/400 to 20/200 but did not close the MH. During subsequent three years of follow-up without any treatment, the MH did not close. Seven years after the surgery, she visited us for cataract surgery in her right eye, and the optical coherence tomography (OCT) examination coincidentally found closure of the MH in her left eye. The visual acuity of her left eye remained 20/200 despite the MH closure.
ILM peeling might indirectly contribute to the closure of MH at seven years after the surgery although the mechanism is unclear. Sharing the serial OCT images until the MH closure would help us explore the mechanisms of ILM peeling to close MH and develop rational surgery technique manipulating ILM for MH.
报告一例在内界膜(ILM)剥除术后七年黄斑裂孔(MH)闭合的病例。
一名66岁女性左眼出现黄斑裂孔。行玻璃体平坦部玻璃体切除术联合ILM剥除及注入SF6气体,术后俯卧位一周,视力从20/400略有提高至20/200,但黄斑裂孔未闭合。在随后三年的无任何治疗的随访期间,黄斑裂孔未闭合。手术七年之后,她因右眼白内障手术前来就诊,光学相干断层扫描(OCT)检查意外发现其左眼黄斑裂孔已闭合。尽管黄斑裂孔已闭合,但其左眼视力仍为20/200。
尽管机制尚不清楚,但ILM剥除可能在术后七年间接促成黄斑裂孔的闭合。分享黄斑裂孔闭合前的系列OCT图像将有助于我们探索ILM剥除闭合黄斑裂孔的机制,并开发合理的手术技术来处理用于黄斑裂孔的ILM。