Two cases of severe degeneration of the macula following vitrectomy with indocyanine green-assisted internal limiting membrane peeling for idiopathic macular hole

Abstract

We describe three eyes of two cases of severe degeneration of the macula following vitrectomy with indocyanine green-assisted internal limiting membrane peeling for idiopathic macular hole. We need to remember the possibility of these complications and have to select the procedures that are safest to use for macular hole surgery.

Fig. (1)

Preoperative optical coherence tomography of both eyes in case 1. Left figure shows right eye (stage III) and right figure is left eye (stage IV).

Fig. (2)

Postoperative optical coherence tomography in case 1. Left figure is the right eye and the right figure is the left eye. Both holes are closed.

Fig. (3)

Postoperative fundus photograph of case 1. A yellow round degenerative lesion is seen in the fovea. Irregular degeneration foci associated with pigment deposition can be seen just temporal to the lesion. (a, right eye; b, left eye).

Fig. (4)

Fluorescein angiogram taken after vitrectomy shows hypofluorescence or blockage of dye in the area with pigment epithelial proliferation in case 1. Hyperfluorescence is noted in the area surrounding the pigment cell proliferation. Many tiny hypofluorescent spots are seen in these areas. (a, right eye; b, left eye).

Fig. (5)

Optical coherence tomograms of left eye of Case 2. a: Preoperative optical coherence tomogram showing stage IV macular hole. b: Postoperative optical coherence tomogram showing that the macular hole is closed.

Fig. (6)

Postoperative fundus photograph showing hyperpigmentation around the macular hole and degeneration of pigment the epithelium within the peeled area of internal limiting membrane in case 2.

Fig. (7)

Fluoresceint angiogram and indocyanine green angiogram of the left eye of Case 2. a: Postoperative fluorescein angiogram showing hypofluorescence and hyperfluorescence areas. b: Postoperative indocyanine green angiogram showing hypofluorescence in the area where ILM was peeled.