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Conversion from type 2 to type 1 macular hole closure after surgery in high myopia
Ramesh Venkatesh1, Arpitha Pereira2, Nikitha Gurram Reddy1
1Departemnt of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India.
BMJ Case Reports
|August 11, 2021
Summary
This case study shows spontaneous conversion from type 2 to type 1 macular hole closure after surgery in high myopia. This natural progression improved both anatomical closure and visual acuity.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- High myopia presents unique challenges for macular hole (MH) surgery.
- Standard surgical approaches include pars plana vitrectomy with internal limiting membrane peeling and tamponade.
Observation:
- A patient with high myopia and a full-thickness macular hole developed type 2 closure post-surgery with epiretinal tissue.
- Optical coherence tomography (OCT) documented the initial closure type and subsequent changes.
Findings:
- Spontaneous conversion from type 2 to type 1 macular hole closure was observed at 6 weeks post-surgery.
- This conversion was associated with a thin epimacular tissue bridge and improved visual acuity from 20/120 to 20/80.
Implications:
- Early spontaneous closure conversion can lead to favorable anatomical and visual outcomes in macular hole surgery.
- This highlights the dynamic nature of macular hole closure and the potential for natural improvement over time.
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