title: Macular hole formation and spontaneous closure after vitrectomy for central retinal vein occlusion.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.affiliation: Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, 1 Anna Nagar, 625 020, Madurai, Tamil Nadu, India. daksh@aravind.org
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Shukla
authors.forename: Anand
authors.initials: A
authors.lastname: Rajendran
authors.forename: Ramasamy
authors.initials: R
authors.lastname: Kim
mesh_terms: D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D009898:Optic Disk / Q000601:surgery*; D012075:Remission, Spontaneous; D012167:Retinal Perforations / Q000209:etiology* / Q000503:physiopathology*; D012170:Retinal Vein Occlusion / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy