Department of Ophthalmology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
BMC Ophthalmol. 2022 Mar 24;22(1):132. doi: 10.1186/s12886-022-02354-6.
Full-thickness idiopathic macular hole (IMH) usually causes serious visual deformities and visual acuity loss. Pseudophakic cystic macular edema, also known as Irvine-Gass syndrome, is another entity that causes visual disturbances, and occurs mainly after cataract extraction. We present a case report of a patient that was diagnosed with a full-thickness macular hole that spontaneously closed after the resolution of an Irvine-Gass syndrome, which occurred after an uneventful cataract extraction.
A 75 years-old female presented with the complaints of decreased visual acuity and color contrast sensitivity on both eyes (OU) and central visual field deformations on her left eye (LE). She was diagnosed with a full-thickness IMH on her LE, and cataract on OU. After an uneventful cataract extraction via phacoemulsification, she developed an Irvine-Gass syndrome at her LE, which was treated topically. The IMH closed spontaneously after the resolution of the Irvine-Gass syndrome, and the patient is being followed with no further complaints.
The exact mechanism for spontaneous closure of full-thickness idiopathic macular holes is still not completely understood. In this case, we hypothesize that the coalesced intraretinal cysts caused by the Irvine-Gass syndrome formed a bridge-like structure connecting the inner walls of the macular hole, thus connecting the remnants of the Muller cells which enabled the full recovery of the normal foveal structure.
特发性全层黄斑裂孔（IMH）通常会导致严重的视觉变形和视力丧失。后发性囊样黄斑水肿，又称 Irvine-Gass 综合征，是另一种导致视觉障碍的疾病，主要发生在白内障手术后。我们报告了一例患者，该患者在 Irvine-Gass 综合征消退后，自发闭合了全层黄斑裂孔，该综合征发生在白内障超声乳化术后无并发症的情况下。
一名 75 岁女性因双眼（OU）视力下降和色觉对比敏感度下降以及左眼（LE）中心视野变形而就诊。她被诊断为左眼全层 IMH 和双眼白内障。在白内障超声乳化术后无并发症的情况下，她左眼发生了 Irvine-Gass 综合征，经局部治疗后得到缓解。在 Irvine-Gass 综合征消退后，IMH 自发闭合，患者无进一步主诉，目前正在接受随访。
全层特发性黄斑裂孔自发闭合的确切机制尚不完全清楚。在本例中，我们假设 Irvine-Gass 综合征引起的视网膜内融合性囊肿形成了类似于桥的结构，连接了黄斑裂孔的内壁，从而连接了 Muller 细胞的残余物，使正常的中心凹结构得以完全恢复。
