Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Dec 5:29:101767.
doi: 10.1016/j.ajoc.2022.101767. eCollection 2023 Mar.

Spontaneous closure of an idiopathic macular hole after epiretinal membrane development

Jesus Hernan Gonzalez-Cortes  1   2 , Alper Bilgic  2   3 , Jefther De Los Santos Polanco  2 , Alan Baltazar Treviño-Herrera  1 , Aditya Sudhalkar  3   4 , Jesus Emiliano Gonzalez-Cantu  1 , Jesus Mohamed-Hamsho  1
Affiliations
Case Reports

Spontaneous closure of an idiopathic macular hole after epiretinal membrane development

Jesus Hernan Gonzalez-Cortes et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To report non-operative closure of an idiopathic full thickness macular hole (FTMH) spontaneous secondary to the development of a macular epiretinal membrane (ERM).

Observations: A 68-year-old woman, with no relevant medical history, and a 6-month history of decreased visual acuity in her right eye was diagnosed to have an idiopathic FTMH. The patient refused surgery and the FTMH was followed-up for seven years. The spectral domain optical coherent tomography follow-up showed the evolution of the FTMH and its spontaneous closure after development of an ERM. In the presence of an ERM with vitreo-papillary detachment, it is possible that the centripetal forces involved helped bring together the edges of the macular hole resulting in a possible spontaneous closure. Additionally and separately, the presence of an ERM may act as scaffolding for Muller cell migration and consequent macular hole closure.

Conclusions and importance: Development of an ERM was followed by non-operative FTMH closure in this specific case. It is important to note, that this is an extraordinary situation in which the patient had a favorable anatomical evolution despite having rejected conventional surgical intervention. Studies aimed at determining the mechanisms and situations in which these cases occur could provide answers that help us make more appropriate decisions. To our knowledge, the present case is the first in the literature to report a spontaneous closure of a FTMH secondary to the appearance and progression of a previously non-existent ERM.

Keywords: Epiretinal membrane; Idiopathic macular hole; Macular hole; Spontaneous closure.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest in any concept or product described in this article. The authors declare no proprietary interest.

Figures

Fig. 1
Fig. 1
SD-OCT images of the FTMH and ERM. A, shows a FTMH and no sign of an ERM. B-D, show progressive enlargement of the macular hole with a slight augmentation of the cystic spaces and lifting of its edges (B–D). After seven years, the appearance of an ERM (white arrow) is shown in (E). F show the presence of the ERM and the complete closure of the FTMH.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Gass J.D.M. Idiopathic senile macular hole: its early stages and pathogenesis. Arch Ophthalmol. 1988;106(5):629–639. - PubMed
    1. McCannel C.A., Ensminger J.L., Diehl N.N., Hodge D.N. Population-based incidence of macular holes. Ophthalmology. 2009;116(7):1366–1369. - PMC - PubMed
    1. Mitchell P., Smith W., Chey T., Wang J.J., Chang A. Prevalence and associations of epiretinal membranes: the blue mountains eye study, Australia. Ophthalmology. 1997;104(6):1033–1040. - PubMed
    1. Rahmani B., Tielsch J.M., Katz J., et al. The cause-specific prevalence of visual impairment in an urban population: the Baltimore Eye Survey. Ophthalmology. 1996;103(11):1721–1726. - PubMed
    1. Duker J.S., Kaiser P.K., Binder S., et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120(12):2611–2619. - PubMed

Publication types

LinkOut - more resources