Management of macular hole with concurrent retinal detachment

Author: Ioannis Keramidas (Greece)

Co-authors: Dimitrios Koutsimpogeorgos, Nikolaos Ziakas, Athanasios Karamitsos

Purpose

To present an interesting case of macular hole with concurrent retinal detachment and discuss the surgical challenges in such cases.

Setting/Venue

Vitreo-retinal service, 2nd University eye clinic of Aristotle University of Thessaloniki. Papageorgiou General Hospital, Thessaloniki, Greece

Methods

An 82 year-old woman with high myopia, retinal detachment and macular hole in her right eye attended the eye emergency clinic of our department. Complete ocular history, ophthalmic clinical examination and imaging (fundus colour photography and optical coherence tomography) were performed before and after the surgery. The surgical procedure was recorded: a 25G pars plana vitrectomy, ILM peeling was performed and the hyaloid cavity was filled with C3F8 20%. Postoperative instructions for face-down positioning were given to the patient.

Results

Best corrected visual acuity was improved from hand movement to 1/10 after surgery. Complete closure of macular hole and successful re-attachment of the retina succeeded after surgery.

Conlusions

In rare cases, a macular hole can co-exist with retinal detachment. Standard vitrectomy with ILM peeling and injection of internal tamponade gas could be an suitable surgical approach to address these challenging cases.

Financial Disclosure

None