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DOI: 10.1055/a-2760-4920
Delayed Spontaneous Closure of a Full Thickness Macular Hole with Foveoschisis after Failed Primary Vitrectomy
Verzögerter spontaner Verschluss eines durchgreifenden Makulaforamens mit Foveoschisis nach primär erfolgloser VitrektomieAuthors
Background
Myopic traction maculopathy (MTM) affects 9 – 34% of highly myopic eyes and represents a major cause of central vision loss among these patients [1], [2]. Although MTM can remain stable over long periods of time, progression sometimes occurs and is often associated with the appearance of subretinal fluid, indicating the need for surgical intervention to prevent the development of full-thickness macular holes (FTMH) or retinal detachment [3], [4]. Various approaches have been described in the literature, including episcleral macular [5] and suprachoroidal scleral buckling [6], pars plana vitrectomy (PPV) with gas or silicone oil tamponade combined with internal limiting membrane (ILM) peeling – more recently modified with various peeling and ILM-flap techniques [7]. Although high anatomical success rates have been achieved with these procedures, repeated surgeries are sometimes necessary to achieve closure of the macular hole [8]. Here, we report a rare case of spontaneous FTMH closure after an initially failed surgical attempt.
Publication History
Received: 24 September 2025
Accepted: 19 November 2025
Article published online:
04 February 2026
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References
- 1 Baba T, Ohno-Matsui K, Futagami S. et al. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia. Am J Ophthalmol 2003; 135: 338-342
- 2 Matsumura S, Sabanayagam C, Wong CW. et al. Characteristics of myopic traction maculopathy in myopic Singaporean adults. Br J Ophthalmol 2021; 105: 531-537
- 3 Matsumura N, Ikuno Y, Tano Y. Posterior Vitreous Detachment and Macular Hole Formation in Myopic Foveoschisis. Am J Ophthalmol 2004; 138: 1071-1073
- 4 Jo Y, Ikuno Y, Nishida K. Retinoschisis: A predictive factor in vitrectomy for macular holes without retinal detachment in highly myopic eyes. Br J Ophthalmol 2012; 96: 197-200
- 5 Tanaka T, Ando F, Usui M. Episcleral macular buckling by semirigid shaped-rod exoplant for recurrent retinal detachment with macular hole in highly myopic eyes. Retina 2005; 25: 147-151
- 6 El Rayes EN. Supra choroidal buckling in managing myopic vitreoretinal interface disorders. 1-Year Data Retina 2014; 129-135
- 7 Kuriyama S, Hayashi H, Jingami Y. et al. Efficacy of inverted internal limiting membrane flap technique for the treatment of macular hole in high myopia. Am J Ophthalmol 2013; 156: 125-131
- 8 Sayanagi K, Ikuno Y, Tano Y. Reoperation for persistent myopic foveaschisis after primary vitrectomy. Am J Ophthalmol 2006; 141: 414-417
- 9 Meng J, Chen Y, Cheng K. et al. LONG-TERM PROGRESSION PATTERN OF MYOPIC TRACTIONAL MACULOPATHY: Outcomes and Risk Factors. Retina 2023; 43: 1189-1197
- 10 Li J, Liu B, Li Y. et al. CLINICAL CHARACTERISTICS OF EYES WITH DIFFERENT GRADES OF MYOPIC TRACTION MACULOPATHY: Based on the New Classification System. Retina 2021; 41: 1496-1501
- 11 Chen Y, Wang J, Ye X. et al. The Role of Internal Limiting Membrane Flap for Highly Myopic Macular Hole Retinal Detachment: Improving the Closure Rate but Leading to Excessive Gliosis. Front Med (Lausanne) 2021; 8: 812693
- 12 Poh SSJ, Tsai ASH, Chou HD. et al. Internal Limiting Membrane Flap Enhances Macular Hole Closure Rates in Highly Myopic Eyes: A Case-Control Study. Clin Ophthalmol 2025; 19: 2615-2624
- 13 Serhan HA, Ahmed A, Chaudhry M. et al. Macular Buckling for Myopic Traction Maculopathy: A Comprehensive Systematic Review and Meta-Analysis. Am J Ophthalmol 2025; 270: 25-34
- 14 Zhao X, Song H, Tanumiharjo S. et al. Macular buckling alone versus combined inverted ILM flap on macular hole-associated macular detachment in patients with high myopia. Eye (Lond) 2023; 37: 2730-2735
- 15 Cao JL, Kaiser PK. Surgical Management of Recurrent and Persistent Macular Holes: A Practical Approach. Ophthalmol Ther 2021; 10: 1137
- 16 Shi Y, Feng L, Li Y. et al. Outcomes of revision surgery for idiopathic macular hole after failed primary vitrectomy. Front Med (Lausanne) 2023; 10: 1169776
- 17 Abdul-Kadir MA, Lim LT. Update on surgical management of complex macular holes: a review. Int J Retina Vitreous 2021; 7: 1-13
- 18 Yang J, Xia H, Liu Y. et al. Ellipsoid Zone and External Limiting Membrane-Related Parameters on Spectral Domain-Optical Coherence Tomography and Their Relationships With Visual Prognosis After Successful Macular Hole Surgery. Front Med (Lausanne) 2021; 8: 779602
- 19 Spaide RF. “Dissociated optic nerve fiber layer appearance” after internal limiting membrane removal is inner retinal dimpling. Retina 2012; 32: 1719-1726
- 20 Sheng Y, Jain M, Sahoo N. et al. Medical Therapy for Large Idiopathic Full-Thickness Macular Holes. Retin Cases Brief Rep 2024; 18: 539-543
- 21 Lee YM, Bahrami B, Baranage D. et al. Topical dorzolamide for macular holes: A randomised, double-blind, placebo-controlled trial. Clin Exp Ophthalmol 2024; 52: 870-879
- 22 Lee YM, Bahrami B, Chan WO. TOPICAL CARBONIC ANHYDRASE INHIBITORS CLOSING BILATERAL SECONDARY MACULAR HOLES AND A REVIEW OF LITERATURE. Retin Cases Brief Rep 2024; 18: 683-686
- 23 Marques RE, Sousa DC. Macular Hole Closure with Topical Carbonic Anhydrase Inhibitor. Ophthalmol Retina 2019; 3: 304
