Surgery for macular holes associated with unusual concomitant pathologies
A 33-year-old man presented with gradual, progressive diminution of vision in the right eye for 1 year. BCVA was 20/60 in the right eye. The left eye showed clinical anophthalmos. Fundus examination of the right eye showed optic disc pit in the temporal part of the optic nerve head. A large FTMH with surrounding neurosensory detachment was noted []. FFA confirmed optic disc pit with no evidence of leakage from any other point []. OCT showed FTMH with schisis like separation of outer and inner retinal layers with large subretinal fluid collection [Figure and ]. The apex diameter of the hole was 526 microns. The patient underwent three-port pars plana vitrectomy. After inducing posterior vitreous detachment, the ILM was stained using 0.25 mg/ml Brilliant Blue G for 2 min and then peeled. C3F8 (14%) was used as a tamponade. At 3 months follow-up, fundus examination showed non-closure of MH. Spectral domain optical coherence tomography (SD-OCT) showed flattening of the edges of the hole as well as the neurosensory elevation []. However, the isolated pockets of intraretinal fluid persisted. At last follow-up BCVA was 20/80.