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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ang GS, Ang AJS, Burton RL (2004) Iatrogenic macular hole and consequent macular detachment caused by intravitreal trypan blue injection. Eye 18:759–760
Hirakata A, Okada AA, Hida T (2005) Long-term results of vitrectomy without laser treatment for macular detachment associated with an optic disc pit. Ophthalmology 112:1430–1435
Martinez-Jardon CS, Meza-de Regil A, Dalma-Weiszhausz J, Leizaola-Fernandez C, Morales-Canton V, Guerrero-Naranjo JL, Quiroz-Mercado H (2005) Radial optic neurotomy for ischaemic central vein occlusion. Br J Ophthalmol 89:558–561
Opremcak EM, Bruce RA, Lomeo MD, Ridenour CD, Letson AD, Rehmar AJ (2001) Radial optic neurotomy for central retinal vein occlusion. Retina 21:408–415
Reddy CV, Folk JC, Feist RM (1996) Microholes of the macula. Arch Ophthalmol 114:413–416
Tadayoni R, Massin P, Haouchine B, Cohen D, Erginay A, Gaudric A (2001) Spontaneous resolution of small stage 3 and 4 full-thickness macular holes viewed by optical coherence tomography. Retina 21:186–189
Takaya K, Suzuki Y, Nakazawa M (2005) Massive hemorrhagic retinal detachment during radial optic neurotomy. Graefes Arch Clin Exp Ophthalmol 23:1–3
Yamamoto S, Takatsuna, Sato E, Mizunoya S (2005) Central retinal artery occlusion after radial optic neurotomy in a patient with central retinal vein occlusion. Am J Ophthalmol 139:206–207
Yoon K, Seo M (2003) Macular hole after peeling of the internal limiting membrane in diabetic macular oedema. Ophthalmic Surg Lasers Imaging 34:478–479
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shukla, D., Rajendran, A. & Kim, R. Macular hole formation and spontaneous closure after vitrectomy for central retinal vein occlusion. Graefe's Arch Clin Exp Ophthalmo 244, 1350–1352 (2006). https://doi.org/10.1007/s00417-006-0258-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-006-0258-x