Macular Hole Self Closure While Awaiting Pre-operative Clearance

Abstract

A 69-year-old white woman with a history of vitreomacular traction (VMT) presented with a 2-week history of visual loss in the right eye. Visual acuity, with correction, measured 20/200 in the right eye. Examination revealed a partial posterior vitreous detachment and a stage 2 full-thickness macular hole (FTMH). Spectral-domain optical coherence tomography (SD-OCT) testing confirmed a stage 2 FTMH with VMT. Pars plana vitrectomy without internal limiting membrane peeling was planned and the patient was sent for preoperative clearance, where she was diagnosed with atrial fibrillation and wanted to delay surgery. Two months later, the patient returned for follow-up with a visual acuity of 20/80, a closed macular hole, and an incomplete posterior vitreous detachment in her right eye. Four months later, the patient exhibited a completely closed FTMH with a visual acuity of 20/30. Spontaneous resolution of FTMHs (stages 2 to 4) in the adult population is an extremely rare event, occurring in less than 4% of affected eyes. We describe a patient with a stage 2 FTMH who exhibited spontaneous resolution due to the resolution of VMT while awaiting preoperative clearance. [Ophthalmic Surg Lasers Imaging Retina 2025;56:54-56.].