J Korean Ophthalmol Soc.  2013 Sep;54(9):1379-1385.

Spontaneous Resolution of Vitreoretinal-Iinterface Disorders

• Baek JW
• Yang JW
• Park YH

Abstract

PURPOSE
To review the mechanisms and clinical patterns of spontaneous resolution of vitreoretinal interface disorders by analyzing cases and available literature on macular hole (MH), vitreoretinal traction (VMT), and epiretinal membrane (ERM).
METHODS
Medical records and optical coherence tomography (OCT) images of patients with spontaneous resolution of MH, VMT, and ERM were reviewed.
RESULTS
Two eyes with VMT, 3 eyes with idiopathic MH, 3 eyes of traumatic MH (including 1 eye with electrical burn), and 2 eyes with ERM showed spontaneous resolution. All eyes except traumatic MH reached a visual acuity better than 0.5 after resolution. All idiopathic MHs achieved anatomic closure in 6 months, and traumatic MHs in 1 month except for the electrical burn case. Seven out of 10 eyes experienced complete posterior vitreous detachment (PVD) during resolution.
CONCLUSIONS
Some cases of vitreoretinal interface disorders can resolve spontaneously with complete PVD or other mechanisms. Indicators predicting spontaneous resolution should be considered in patients with vitreoretinal interface disorder.

Keyword

Epiretinal membrane; Macular hole; Posterior vitreous detachment; Vitreoretinal interface disorder; Vitreomacular traction

MeSH Terms

Burns
Epiretinal Membrane
Eye
Humans
Medical Records
Retinal Perforations
Tomography, Optical Coherence
Traction
Visual Acuity
Vitreous Detachment

Figure

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  Figure 1. Optical coherence tomography (M-OCT) of idio-pathic vitreomacular traction (VMT) with stage 1a macular hole(MH) (case 2). Initial M-OCT showed VMT with stage 1a MH and subfoveal cysts (A, B). Eight months after the first visit, M-OCT of the same patient revealed closure of macular hole with complete PVD (white arrow) and subfoveal cysts were no longer apparent (C).

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  Figure 2. Optical coherence tomography (M-OCT) of idio-pathic stage 1a macular hole (MH) (case 4). Initial M-OCT showed stage 1a MH with preexisting complete posterior vit-reous detachment (white arrow at upper right) (A). Four months after the first visit, M-OCT revealed closure of MH with disrupted retinal pigment epithelium and photoreceptor inner/outer segment junction (B). Seven months after the first visit, complete closure of MH was accomplished (C).

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  Figure 3. Optical coherence tomography (M-OCT) of idiopathic stage 2 eccentric macular hole (MH) (case 5). Initial M-OCT showed stage 2 eccentric MH (A). Two months after the first visit, M-OCT revealed closure of MH by retinal bridging with persis-tent subretinal fluid (B). Five months after the first visit, complete closure of MH was seen but defects at the photoreceptor in-ner/outer segment junction level remained (C). Complete PVD was observed during the process by slit-lamp funduscopic examination (not shown in the figure).

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  Figure 4. Optical coherence tomography (M-OCT) of traumatic macular hole (MH) (case 6). Initial M-OCT showed MH with sub-retinal hemorrhage (white arrow) and subretinal fluid (A). One week after the trauma, M-OCT revealed marked decreased MH size with decreased subretinal fluid (B). One month after the first visit, complete closure of MH was seen but small amounts of subretinal fluid persisted with irregular hyperreflectivity at the retinal pigment epithelium and photoreceptor inner/outer segment level (C).

• 

  Figure 5. Optical coherence tomography (M-OCT)of traumatic macular hole (MH) by electrical burn (case 8). The patient visited ophthalmologic department 3 months after the trauma with gradual progression of decreased visual acuity. M-OCT at the first visit showed MH and complete posterior vitreous detachment (white arrow) (A). One month after the first visit, M-OCT revealed de-creased MH size with decreased subretinal fluid (B). Five months after the first visit, complete closure of MH was seen but defect of photoreceptor inner/outer segment junction persisted (C).

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  Figure 6. Optical coherence tomography (M-OCT)of epiretinal membrane (ERM) with pseudohole (case 9). Initial M-OCT showed ERM with pseudohole and incomplete posterior vitreous detachment (PVD) (A). One month after the first visit, M-OCT revealed resolution of ERM with complete PVD, decreased size of pseudohole and intraretinal fluid (B). Nine months after the first visit, in-traretinal fluid further decreased but still persisted (C).

Reference

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