title: Case report: successful closure of a large macular hole secondary to uveitis using the inverted internal limiting membrane flap technique.
abstract: BACKGROUND
  Macular holes (MHs) are one of the complications of posterior uveitis that can significantly disturb vision. Conventional MH surgery (vitrectomy, internal limiting membrane (ILM) peeling, and gas tamponade) has been reported to show lower closure rates in patients with MHs secondary to uveitis than in patients with idiopathic MHs. Recently, the inverted ILM flap technique has been reported to be effective for treating refractory MHs. Here, we describe the application of this technique in a patient with a large MH secondary to uveitis, and its successful closure.
  
  
  METHODS
  An 80-year-old woman presented with a chronic, large MH secondary to uveitis. The minimum aperture diameter of the MH was 569 μm and extensive post-inflammatory chorioretinal atrophy was present, which included the juxtafoveal region. Vitrectomy with the inverted ILM flap technique assisted by low molecular weight hyaluronic acid was performed. Three days after surgery, the MH was closed successfully, without excessive gliosis.
  
  
  CONCLUSIONS
  The inverted ILM flap technique may be the preferred surgical procedure for the treatment of large MHs secondary to uveitis.
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. p6fb9zzp@s.okayama-u.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hirano
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. p6fb9zzp@s.okayama-u.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morizane
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. tetuhiro1129@gmail.com.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Kawata
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. shuheik@cc.okayama-u.ac.jp.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Kimura
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. hmo529@okayama-u.ac.jp.
authors.forename: Mio
authors.initials: M
authors.lastname: Hosokawa
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. shiode2001@yahoo.co.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shiode
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. pkjv7k6x@okayama-u.ac.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Doi
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. mika.hosogi.0823@gmail.com.
authors.forename: Mika
authors.initials: M
authors.lastname: Hosogi
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. atsushi@okayama-u.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fujiwara
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama City, Okayama, 700-8558, Japan. fumio327@symphony.plala.or.jp.
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
mesh_terms: D000369:Aged, 80 and over; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence; D015866:Uveitis, Posterior / Q000150:complications*; D014821:Vitrectomy
chemical_list: D006820:Hyaluronic Acid