Dhananjay Shukla1, Anand Rajendran, Ramasamy Kim. 1. Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, 1 Anna Nagar, 625 020, Madurai, Tamil Nadu, India. daksh@aravind.org
Abstract
PURPOSE: The purpose was to describe the formation and spontaneous closure of an iatrogenic macular hole after vitrectomy for central retinal vein occlusion (CRVO). METHODS: A 45-year-old woman presented with loss of vision in the right eye due to CRVO. The left eye was normal. Best-corrected visual acuity (BCVA) was 3/60 in the right eye and 6/6 in the left. She underwent vitrectomy and radial optic neurotomy (RON) in the right eye. Fluorescein angiography and optical coherence tomography (OCT) were performed pre-operatively, on the first post-operative day, and subsequently at 1, 3, 6 and 12 months. RESULTS: There were no intra-operative complications. On the first post-operative day, fundus examination of the right eye revealed a small macular hole, confirmed by OCT. No additional intervention was carried out. Examination after a month revealed clearing of retinal haemorrhages, resolution of macular oedema and spontaneous closure of the macular hole. The closure was maintained until the last follow-up a year later. BCVA improved to 6/24 by 3 months, and was stable over the follow-up period. The left eye remained unchanged. CONCLUSION: While performing vitrectomy for CRVO, the induction of posterior vitreous detachment may deroof a foveal cyst in the highly oedematous macula to form a macular hole. A small macular hole, however, may close spontaneously without further intervention.
PURPOSE: The purpose was to describe the formation and spontaneous closure of an iatrogenic macular hole after vitrectomy for central retinal vein occlusion (CRVO). METHODS: A 45-year-old woman presented with loss of vision in the right eye due to CRVO. The left eye was normal. Best-corrected visual acuity (BCVA) was 3/60 in the right eye and 6/6 in the left. She underwent vitrectomy and radial optic neurotomy (RON) in the right eye. Fluorescein angiography and optical coherence tomography (OCT) were performed pre-operatively, on the first post-operative day, and subsequently at 1, 3, 6 and 12 months. RESULTS: There were no intra-operative complications. On the first post-operative day, fundus examination of the right eye revealed a small macular hole, confirmed by OCT. No additional intervention was carried out. Examination after a month revealed clearing of retinal haemorrhages, resolution of macular oedema and spontaneous closure of the macular hole. The closure was maintained until the last follow-up a year later. BCVA improved to 6/24 by 3 months, and was stable over the follow-up period. The left eye remained unchanged. CONCLUSION: While performing vitrectomy for CRVO, the induction of posterior vitreous detachment may deroof a foveal cyst in the highly oedematous macula to form a macular hole. A small macular hole, however, may close spontaneously without further intervention.
Authors: C S Martínez-Jardón; A Meza-de Regil; J Dalma-Weiszhausz; C Leizaola-Fernández; V Morales-Cantón; J L Guerrero-Naranjo; H Quiroz-Mercado Journal: Br J Ophthalmol Date: 2005-05 Impact factor: 4.638