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Updated: Jul 12, 2025
Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report
Published on: February 12, 2018
Macula-Off Retinal Detachment with Refractory Macular Hole Previously Closed with Autologous Platelet-Rich Plasma: A
Guglielmo Parisi1, Federico Ricardi1, Giacomo Boscia1
1Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy.
Abstract:
The purpose of this report was to present a case of a refractory full-thickness macular hole (FTMH) complicated with recurrent retinal detachment (RD) previously treated with an autologous platelet-rich plasma (aPRP) plug. A 65-year-old male patient presented to our department with a FTMH, RD, and a giant retinal break. Preoperative best corrected visual acuity (BCVA) was 1.40 logMAR (20/500). A 25-G pars plana vitrectomy (PPV) was performed, with peripheral retinal-breaks laser barrage, peeling of the internal limiting membrane, and silicon oil injection. One month later, spectral domain optical coherence tomography (SD-OCT) showed the persistence of the FTMH with a diameter of 712 μm. Therefore, the patient underwent silicon oil removal and aPRP injection with good anatomical outcome and improvement of BCVA to 0.6 log-MAR (20/80). Two months later a recurrence of macula-off RD was detected, but SD-OCT showed that the aPRP plug was still in place and kept the two margins of the macular hole together. The patient underwent a further PPV with silicon oil injection and subsequent silicon oil removal with no postoperative complications. Two months later, the retina remained attached, SD-OCT confirmed FTMH closure and BCVA was 0.52 logMAR (20/63). In conclusion, this case report aims to underline the remarkable efficacy of aPRP in promoting FTMH closure, which was maintained despite subsequent recurrence of macula-off RD.
Insights
Autologous platelet-rich plasma (aPRP) effectively closed a refractory full-thickness macular hole (FTMH) despite recurrent retinal detachment. This case highlights aPRP
Area of Science:
- Ophthalmology
- Regenerative Medicine
Background:
- A case report detailing a 65-year-old male with a refractory full-thickness macular hole (FTMH) and recurrent retinal detachment (RD).
- Initial treatment involved pars plana vitrectomy (PPV) with silicon oil injection.
Observation:
- Persistence of FTMH (712 μm diameter) noted one month post-initial PPV.
- Autologous platelet-rich plasma (aPRP) injection led to anatomical closure and improved visual acuity.
- Recurrent macula-off RD occurred two months later, yet the aPRP plug remained intact, holding the macular hole margins together.
Findings:
- Successful FTMH closure confirmed by SD-OCT after a second PPV and silicon oil removal.
- Visual acuity improved to 0.52 logMAR (20/63) with the retina attached.
- The aPRP plug demonstrated sustained efficacy in maintaining FTMH closure despite subsequent RD recurrence.
Implications:
- Autologous platelet-rich plasma (aPRP) shows significant potential for promoting and maintaining full-thickness macular hole closure.
- This approach may offer a viable option for managing complex macular hole cases refractory to conventional treatments.
- Further research is warranted to explore the long-term efficacy and broader applicability of aPRP in retinal surgery.
