유리체절제술과 내경계막제거술 후 9개월에 지연 폐쇄된 특발성 황반원공 1예

Delayed Closure of Idiopathic Macular Hole after Vitrectomy, Internal Limiting Membrane Peeling, and Gas Tamponade

Purpose: To report a case of delayed idiopathic macular hole closure after vitrectomy, internal limiting membrane peeling, and gas tamponade. Case summary: A 69-year-old female complained of visual disturbance in her left eye. At presentation, her visual acuity was 20/100 in the left eye. Fundus examination and optical coherence tomography revealed a full-thickness macular hole 489 μm in diameter as well as posterior vitreous detachment. Hence, vitrectomy, concurrent cataract surgery, internal limiting membrane peeling and gas tamponade were performed. One month postoperatively, the hole remained unclosed, although decreased in size to 378 μm. At 2 months, cystoid macular edema developed and postoperatively the hole diameter decreased gradually to 311 μm, 252 μm and 156 μm at 2, 3, and 5 months, respectively. Finally, the hole was closed upon the resolution of macular edema at 9 months. However, the visual acuity of 20/100 remained unchanged. Conclusions: Delayed closure of holes which may be related to cystoid macular edema, can develop after macular hole surgery. J Korean Ophthalmol Soc 2014;55(5):775-779