Spontaneous Closure of a Macular Hole in a Vitrectomized Eye for a Rhegmatogeneous Retinal Detachment: A Case Report

Macular hole formation after pars plana vitrectomy for rhegmatogenous retinal detachment is of rare occurrence. It is commonly held to be the result of interplay of forces between remnants of the vitreous cortex and the retina. The treatment remains exclusively surgical by vitrectomy, with or without internal limiting membrane peeling, to relieve traction forces. This case report describes a spontaneous closure of a macular hole in a 67 years old male patient, in whom vitrectomy was performed for a rhegmatogenous retinal detachment. The patient had an initial postoperative improvement of his visual acuity. Four weeks postoperatively, he presented a full thickness macular hole documented by an OCT-SD showing a thin epiretinal membrane, and refused any further surgical intervention. A monthly surveillance was suggested. One month later, the patient reported an improvement in his visual acuity and the OCT-SD revealed a complete closure of his macular hole without any treatment being provided. To our knowledge, there have only been 2 similar cases described in literature suggesting the hypothesis of tangential vitreomacular tractions due to vitreous cortex remnants. Herein, we report the case of a spontaneous closure of a macular hole, OCT-SD documented, with a visible epiretinal membrane.