Macular Hole Retinal Detachment Following Surgical Removal of Myopic Choroidal Neovascularization: A Case Report

Abstract

AIM: To report a case of Japanese woman who developed macular hole retinal detachment (MHRD) following surgical removal of myopic choroidal neovascularization (CNV).

PATIENT: The best-corrected visual acuity (BCVA) was 20/200 with -17.0 diopters in her left eye. She was diagnosed with juxtafoveal CNV and subretinal hemorrhage secondary to myopia. She underwent surgical removal of the CNV. Postoperatively, the CNV was not detected. 2.5 years postoperatively, the BCVA was 20/16. At 6.5 years postoperatively, however the patient presented with worsening vision. The BCVA was 20/220. Funduscopic examination as well as optical coherence tomography (OCT) revealed retinal detachment involving the posterior pole with a macular hole. The patient underwent a vitrectomy without removal of the internal limiting membrane (ILM), and silicone oil tamponade. Finally, Silicone oil was removed. At the latest visit, a flattened macula with a closed macular hole was observed by OCT. The BCVA was 20/100.

CONCLUSION: In this case, the reason for the development of MHRD without vitreous and spontaneous closure of the macular hole without vitreous or removal of the ILM is unknown. A higher index of suspicion of MHRD may be warranted for patients who complain of sudden vision loss after surgical treatment for myopic CNV.