J Korean Ophthalmol Soc.  2019 Mar;60(3):287-291. 10.3341/jkos.2019.60.3.287.

Surgical Repair of a Full-thickness Macular Hole in Retinitis Pigmentosa: a Case Report

• Kim S
• Yeo JH
• Kim JG

• KMID: 2440458
• DOI: http://doi.org/10.3341/jkos.2019.60.3.287

Abstract

PURPOSE
To report the long-term outcome after surgical repair of a full-thickness macular hole (FTMH) in a patient with retinitis pigmentosa (RP).
CASE SUMMARY
A 55-year-old male who had been diagnosed with retinitis pigmentosa in both eyes 5 years earlier presented with decreased visual acuity in his left eye over the last 6 months. On examination, his Snellen best-corrected visual acuity (BCVA) was 1.0 in the right eye and 0.3 in the left eye. Slit-lamp examination of the anterior segment was remarkable only for posterior chamber intraocular lenses in each eye. Fundus examination demonstrated extensive bony spicule-like pigmentation in the mid-peripheral region in both eyes and a FTMH with approximately one-third disc diameter in the left eye. The optical coherence tomography (OCT) findings confirmed a FTMH with a surrounding cuff of intraretinal fluid and vitreomacular traction in the left eye. The patient underwent 23-gauge pars plana vitrectomy (PPV) with indocyanine green-assisted internal limiting membrane peeling and gas tamponade. One week postoperatively, an anatomically well-sealed macular hole was confirmed by OCT. At the 3-month postoperative follow-up, the BCVA improved to 0.63 and the hole remained closed until his last follow-up (postoperative 6 years).
CONCLUSIONS
Although macular hole is a rare occurrence in RP patients, it should be considered as a cause of significant visual loss in patients with this disorder. Our case suggested that over the long-term, PPV may be tolerable in the management for FTMH in RP.

Keyword

Full-thickness macular hole; Retinitis pigmentosa; Vitrectomy

MeSH Terms

Follow-Up Studies
Humans
Lenses, Intraocular
Male
Membranes
Middle Aged
Pigmentation
Retinal Perforations*
Retinitis Pigmentosa*
Retinitis*
Tomography, Optical Coherence
Traction
Visual Acuity
Vitrectomy

Figure

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  Figure 1. Preoperative fundus photography images of the right (A) and left (B) eyes of the study patient are presented. Note an extensive bony spicule-like pigmentation in the midperipheral region in both eyes and a full-thickness macular hole with approximately one-third disc diameter in the left eye.

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  Figure 2. The preoperative optical coherence tomography images of the right (A) and left (B) eyes of the study patient are presented. Note the full-thickness macular hole with surrounding cuff of intraretinal fluid and vitreomacular traction in left eye.

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  Figure 3. The postoperative fundus photography and optical coherence tomography images of the left eye at 1 month (A, B), 6 years (C, D), respectively. Note that the full-thickness macular hole has resolved in each image.

Reference

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