Apparent Disappearance of a Macular Hole Associated With Development of an Epiretinal Membrane

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A macular hole in a 78-year-old man participating in a long-term follow-up study changed its biomicroscopic appearance dramatically as a result of changes in an epiretinal membrane. The macular hole became invisible and visual acuity improved from 20/70−2 to 20/30−2+2.

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Cited by (104)

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    The data on the incidence of bilateral MH vary considerably from 4.5% to 16.6%.9–13 Although there are numerous case reports of spontaneous resolution of unilateral MH in the literature,14–24 bilateral spontaneous closure is rare, with only one case reported to date to our knowledge.25 We report here a rare case of a 61 years old women who had a spontaneous resolution of bilateral FTMH.

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    Imai et al.10 suggested that proliferation of glial cells and retinal pigment epithelium cells from the edges of holes results in the filling of holes. Lewis et al.11 outlined that formation of epiretinal membrane results in constriction of hole. Takahashi and Kishi12 suggested that reattachment of operculum to the hole edge and bridging of the protruding retinal tissue over the hole result in closure of hole.

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    2012, American Journal of Ophthalmology
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    Although the macular microstructure completely recovered within 3 years, several factors, such as delayed recovery of the IS/OS junction and persistent foveal detachment in the early period after spontaneous closure, appeared to be associated with incomplete recovery of the VA. In regard to the mechanisms of spontaneous closure of idiopathic MH, several hypotheses have been proposed, mainly the following 4, as follows: spontaneous release of vitreous traction,1 shrinkage of a developed epiretinal membrane,2,12,13 glial cell or RPE cell proliferation,2 and bridging of retinal tissue over the MH.6,8 Imai and associates described that stage 2 MHs closed spontaneously with vitreoretinal separation.7

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