Stewart Christopher, Bhangu Jaskaran S, Awad Mahmoud, Williams Gwyn
Ophthalmology, Swansea University, Swansea, GBR.
Ophthalmology, Singleton Hospital, Swansea, GBR.
Cureus. 2025 Apr 25;17(4):e82999. doi: 10.7759/cureus.82999. eCollection 2025 Apr.
Macular holes are vision-threatening retinal conditions that can significantly affect a patient's quality of life. Secondary macular holes, often associated with intricate ocular histories, create significant obstacles in effective patient management. This case report discusses a gentleman in his 60s, whose routine monitoring for proliferative diabetic retinopathy revealed the emergence of a small full-thickness macular hole, likely worsened by his complex ocular history. His ocular history included a pars plana vitrectomy combined with heavy silicone oil tamponade following a traumatic retinal detachment three years earlier, alongside pan-retinal photocoagulation, anti-vascular endothelial growth factor and steroid injections for his diabetic eye disease. Spontaneous closure of the full-thickness macular hole within three months not only improved visual acuity from 1.04 LogMAR to 0.68 LogMAR but also illustrates the retina's natural reparative capabilities. This underscores the complex aetiology of secondary full-thickness macular holes, highlighting the interplay of trauma, proliferative diabetic retinopathy, anti-vascular endothelial growth factor treatments, and prior surgeries. Observation, especially in smaller secondary holes, can be a practical approach, using the retina's natural reparative processes while avoiding surgical risks.
黄斑裂孔是威胁视力的视网膜疾病，会严重影响患者的生活质量。继发性黄斑裂孔通常与复杂的眼部病史相关，给有效的患者管理带来了重大障碍。本病例报告讨论了一位60多岁的男性，其对增殖性糖尿病视网膜病变的常规监测发现出现了一个小的全层黄斑裂孔，可能因其复杂的眼部病史而恶化。他的眼部病史包括三年前外伤性视网膜脱离后行玻璃体视网膜切除术并联合重硅油填充，以及针对糖尿病眼病的全视网膜光凝、抗血管内皮生长因子和类固醇注射。全层黄斑裂孔在三个月内自发闭合，不仅使视力从1.04 LogMAR提高到0.68 LogMAR，还说明了视网膜的自然修复能力。这突出了继发性全层黄斑裂孔的复杂病因，强调了创伤、增殖性糖尿病视网膜病变、抗血管内皮生长因子治疗和既往手术之间的相互作用。观察，尤其是对于较小的继发性裂孔，可能是一种实用的方法，可以利用视网膜的自然修复过程，同时避免手术风险。
