Hernández MR, González DRE, Ramos LM, Perera ME, Molina SY

Language: Spanish
References: 16
Page: 1-9
PDF size: 288.41 Kb.

ABSTRACT

Macular hole is a disorder of the vitreous-retina interface defined as a full-thickness defect from the internal limiting membrane to the external segments of photoreceptors which typically involves the fovea. The development of optical coherence tomography has improved the diagnosis, treatment and follow-up of vitreous-retina interface diseases, among them macular hole. Pars plana vitrectomy is the surgical technique of choice for macular hole. A case is presented of a female 75-year-old pseudophakic patient with best corrected right eye visual acuity of 0.1 on the Snellen chart. Large macular hole is diagnosed (810 µm) according to its minimum opening, of 8 month's evolution. The following procedures were performed: pars plana vitrectomy, posterior hyalode lifting, inverted internal limiting membrane flap, use of sulfur hexafluoride in a 20% mixture, and positioning of the patient for 24-72 hours. Anatomical closure of the macular hole and a visual recovery of 0.6 Snellen were achieved six months after surgery.

REFERENCES

1. Gaudric A, Tadayoni R. Vitreous surgery for macular disorders. In: Ryan SJ. Retina. London: Elsevier; 2018. p. 6770-834.

2. American Academy of Ophthalmology. Idiopathic macular hole. San Francisco: American Academy of Ophthalmology; 2019 [acceso: 12/08/2020]. Disponible en: https://www.aao.org/guidelines

3. Yuxin F. OCT-based diagnostic criteria for different stages of myopic maculopathy. Ophthalmology. 2019;126(7):1018-32.

4. Tsukahara M. Posterior vitreous detachment as observed by wide-angle OCT imaging. Ophthalmology. 2018;125(9):1372-83.

5. Yee P, Sevgi DD, Abraham J, Srivastava SK, Le T, Uchida A, Ehlers JP. OCT assisted macular hole surgery: outcomes and utility from the Discover study. Br J Ophthalmol. 2020;0:1-7. DOI: http://dx.doi.org/10.1136/bjophthalmol-2020-316045

6. Duker JS, Kaiser PK. The International Vitreomacular Traction Study Group Classification of Vitreomacular Adhesion, Traction, and Macular Hole. Ophthalmology. 2013;120(12):2611-19.

7. Kelly NE, Wendel RT: Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991;109:654-59.

8. Michalewska Z, Michalewski J, Adelman R, et al. Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology. 2010;117(10):2018-25.

9. Rossi T, Gelso A. Macular hole closure patterns associated with different internal limiting membrane flap techniques. Graef Arch Clin Experim Ophtalmol. 2017;255(6):1073-8.

10. Rizzo S. Internal limiting membrane peeling versus inverted flap technique for treatment of full-thickness macular holes: A comparative study in large series of patients. Retina. 2018;38:73-8.

11. Sborgia G. Inverted internal limiting membrane-flap technique for large macular hole: a microperimetric study. Internat J Ret Vitr. 2019;5:44.

12. Kelly NE, Wendel RT: Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991;109:654-59.

13. Baumann C. Effect of inverted internal limiting membrane flap on closure rate, postoperative visual acuity, and restoration of outer retinal layers in primary idiopathic macular hole surgery. Retina. 2019;20. DOI: https://doi.org/10.1097/IAE.0000000000002707

14. Caporossi T. Human amniotic membrane to close recurrent, high myopic macular holes in pathologic myopia with axial length of = 30 mm. Retina. 2019;10. DOI: 10.1097/IAE.0000000000002699

15. Dilraj S. Autologous retinal transplant for refractory macular holes: Multicenter International Collaborative Study Group. Ophthalmology. 2019;126(10):399-1408.

16. Iwasaki M. Retinal layer structures after a large macular hole surgery. Retina. 2019;39(8):1470-7.