Macular hole formation and spontaneous closure after vitrectomy for central retinal vein occlusion.
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.
Shukla
Dhananjay
D
Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, 1 Anna Nagar, 625 020, Madurai, Tamil Nadu, India. daksh@aravind.org
Rajendran
Anand
A
Kim
Ramasamy
R
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