DELAYED SPONTANEOUS CLOSURE OF A FULL-THICKNESS MYOPIC MACULAR HOLE WITH GOOD VISUAL RECOVERY

The aim of this study was to present the longitudinal progression of a myopic macular hole with eventual closure and excellent visual recovery over a decade after initial full-thickness hole formation.

The patient was monitored using time domain and spectral domain optical coherence tomography images over 16 years.

A 68-year-old man with high myopia was referred for surgical evaluation of a full-thickness macular hole and retinal detachment of his left eye, which were repaired. At the initial presentation, the fellow eye demonstrated a lamellar hole, which eventually also progressed to become a full-thickness macular hole. The patient subsequently declined surgery and was observed semiannually over the course of 16 years. At 10 years after the initial injury, the full-thickness macular hole closed spontaneously. The visual recovery was excellent with an acuity of 20/25.

Although surgical intervention remains the mainstay of treatment for macular holes, patients who are not surgical candidates may still have good visual and anatomic outcomes even long after initial hole formation. Lamellar hole epiretinal proliferation material is frequently seen in myopic full-thickness macular holes and may be associated with eventually delayed hole closure because of their slow progression.