Early postoperative recovery of idiopathic macular hole in a young adult.
BACKGROUND
Idiopathic macular holes usually develop in the elderly. We report the case of a spontaneous macular hole in a 23-year-old man.


METHODS
The patient noticed decreased central vision in his left eye since 5 days without any history of trauma or intraocular inflammation. On examination the best corrected visual acuity was 20/20 in the right eye and 20/50 in the left. Fundus biomicroscopy and OCT showed a full-thickness macular hole. Microperimetry demonstrated a scotoma within the macular hole.


RESULTS
2 months later the patient underwent pars plana vitrectomy, ILM-peeling with trypan blue staining and fluid-air exchange followed by face down positioning for 12 h a day for 2 days. On the 4th post-surgical day visual acuity was 20/32 and OCT showed a complete closure of the macular hole. During the further follow-up visual acuity in the left eye improved to 20/20. OCT examination showed a restored foveal depression, and microperimetry demonstrated an increased foveal sensitivity in the area of the previous scotoma.


CONCLUSIONS
The aetiology of the macular hole in this patient is unclear. It is most likely an idiopathic macular hole in a young person. Post-surgical follow-up OCTs and microperimetry disclosed an early recovery of the foveal anatomy and function.
Gassmann
K
K
University Eye Clinic, Basel, Switzerland.
Hasler
P W
PW
Braun
B
B
Prünte
C
C
D000328:Adult; D006801:Humans; D008297:Male; D011184:Postoperative Period; D012167:Retinal Perforations / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D014821:Vitrectomy