Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report

Full-Thickness Macular Hole Caused by Acute Subretinal Hemorrhage From Wet Age-Related Macular Degeneration

Purpose: To present a case of full-thickness macular hole (MH) that developed in association with acute subretinal hemorrhage from wet age-related macular degeneration (AMD). Methods: A retrospective observational review of a single case was performed. Results: An 84-year-old man with wet AMD presented with central vision loss and floaters and was noted to have a subretinal hemorrhage and an associated MH, which subsequently progressed to MH-associated macular detachment. The patient had a pars plana vitrectomy with internal limiting membrane peeling, gas tamponade, and prone positioning, resulting in closure of the MH and improvement in visual acuity. Conclusions: A full-thickness MH developed as a result of foveal dehiscence from an acute hemorrhage caused by choroidal neovascularization in wet AMD.

FULL-THICKNESS MACULAR HOLE FORMATION AND SPONTANEOUS CLOSURE DURING INTRAVITREAL RANIBIZUMAB THERAPY FOR CENTRAL RETINAL VEIN OCCLUSION

PURPOSE

To describe the occurrence of full-thickness macular hole formation and spontaneous closure in a case of central retinal vein occlusion treated with intravitreal ranibizumab.

METHODS

A 67-year-old hypertensive man presented with acute central retinal vein occlusion with macular edema in his left eye for which he received intravitreal ranibizumab.

RESULTS

He developed a FTMH following the second injection, which was kept under observation. Recurrence of intraretinal edema allowed approximation of the MH edges which subsequently achieved closure with further intravitreal RBZ and formation of an epiretinal membrane.

CONCLUSION

Full-thickness macular hole formation in acute central retinal vein occlusion after intravitreal ranibizumab, although rare, can occur in eyes with massive macular edema and absence of posterior vitreous detachment after intravitreal pharmacotherapy. Spontaneous closure of secondary holes can take place with improvement in visual acuity.