SPONTANEOUS CLOSURE OF FULL-THICKNESS MACULAR HOLE AFTER PARS PLANA VITRECTOMY FOR RETINAL DETACHMENT: EVIDENCE OF ELLIPSOID ZONE RESTORATION

Purpose: To describe a case of full-thickness macular hole (FTMH) occurred after pars plana vitrectomy for a macula-sparing rhegmatogenous retinal detachment, which showed a spontaneous closure associated with outer retinal layers restoration. Methods: Case report. Results: A pseudophakic 69-year-old man underwent pars plana vitrectomy for a macula-sparing superior rhegmatogenous retinal detachment in the right eye. Best-corrected visual acuity was 20/20 before surgery. Three weeks after treatment, the patient complained about visual impairment, and an FTMH was detected at fundus examination as well as confirmed by optical coherence tomography scan. The patient was scheduled for a repeated surgery, but FTMH spontaneously closed 18 days after its occurrence as demonstrated by optical coherence tomography showing only a point break of the ellipsoid zone and Verhoeff membrane. The subsequent macular optical coherence tomography scan showed a point-like irregularity at the Verhoeff membrane and regeneration of ellipsoid zone, associated with a progressive improvement in the best-corrected visual acuity. Forty days after the FTMH occurrence, all the retinal layers were completely restored with a complete clinical recovery. Conclusion: Full-thickness macular hole formation and closure after macula-sparing rhegmatogenous retinal detachment repair is a rare event that could be characterized by spontaneous and gradual anatomical restoration of the ellipsoid zone associated with visual acuity improvement, underlying the retinal physiology recovery.