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Case Reports
. 2023 Apr 19;7(3):262-264.
doi: 10.1177/24741264231166694. eCollection 2023 May-Jun.

Full-Thickness Macular Hole in Coats Disease Treated Using the Inverted Internal Limiting Flap Technique

Zofia Anna Nawrocka  1 , Iwona Partyka  2   3 , Zofia Nawrocka  1 , Jerzy Nawrocki  1
Affiliations
Case Reports

Full-Thickness Macular Hole in Coats Disease Treated Using the Inverted Internal Limiting Flap Technique

Zofia Anna Nawrocka et al. J Vitreoretin Dis. .

Abstract

Purpose: To report vitrectomy with the inverted internal limiting membrane (ILM) flap technique in a patient with a full-thickness macular hole (FTMH) and Coats disease. Methods: A case and its long-term findings were analyzed. Results: A 27-year-old patient with Coats disease who was treated 5 years earlier with laser photocoagulation presented with an FTMH. Vitrectomy with the temporal inverted ILM flap technique was performed. The macular hole decreased in size on serial OCT scans but did completely close until 18 months postoperatively. The final visual acuity was 20/40 (0.3 logMAR). The patient's vision remained stable for the next 5 years. Conclusions: Although the healing process after vitrectomy with ILM peeling and the inverted flap technique in an FTMH coexisting with Coats disease is prolonged compared with an idiopathic FTMH, it is still possible to obtain satisfactory anatomic and functional results.

Keywords: Coats disease; FTMH; full-thickness macular hole; inverted ILM flap; inverted flap; vitrectomy.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Laser treatment around telangiectatic vessels is visible.
Figure 2.
Figure 2.
SS-OCT images showing the closure process of the full-thickness macular hole over time (images A-E, DRI OCT Triton [Topcon]; image F, Cirrus HD-OCT [Zeiss]). (A) Full-thickness macular hole on SS-OCT shows intraretinal hyperreflective spots, probably corresponding to an active exudation (arrows). (B) Image from 1 month after vitrectomy with the temporal inverted ILM flap technique and silicone oil tamponade shows flap closure. Some hyperreflective spots were still visible. The VA was 20/200 (1.0 logMAR). (C) Ten months after surgery, an empty space filled with ILM was visible on 1 B-scan. No symptoms of intraocular exudation were noted. (D) At 14 months, the closure still appeared to be incomplete. The VA was 20/63 (0.5 logMAR). (E) Complete closure was achieved 18 months after surgery. The VA was 20/40 (0.3 logMAR). (F) Five years after surgery, photoreceptor and external limiting zone defects were visible, especially at the temporal side of the fovea. The VA was 20/40 (0.3 logMAR). Abbreviations: ILM, internal limiting membrane; SS-OCT, swept-source optical coherence tomography; VA, visual acuity.
See this image and copyright information in PMC

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