Hyperautofluorescent ring in eyes with macular holes
A 71-year-old woman was referred to our department with a diagnosis of MH in her right eye. She reported that her central vision had decreased 15 years earlier, and her doctor informed her that no treatment was available to close the MH at that time. At our initial examination, her decimal BCVA was 0.1 in the right eye and 0.8 in the left eye. The minimal and maximal diameter of the MH was 818 μm and 1,494 μm, respectively ( and ). Optical coherence tomography showed disruptions of the IS/OS line and the external limiting membrane line at the edge of the cuff of subretinal fluid (). A depigmented ring and corresponding hyperautofluorescent ring were observed ( and ).\nCombined phacoemulsification and vitrectomy was performed on the right eye with a 25-gauge ultrahigh-speed cutter under local anesthesia. After core vitrectomy followed by the creation of posterior vitreous detachment, peripheral vitrectomy and 360 degree vitreous shaving was performed. The inverted internal limiting membrane flap technique assisted by Brilliant Blue G staining was performed. The vitreous cavity was filled with 20% sulfur hexafluoride, and she was instructed to maintain a prone position for as long as possible.\nPostoperatively, the MH was anatomically closed but a recovery of both the IS/OS line and the external limiting membrane line was not seen 6 months after vitrectomy ( and ). Fundus autofluorescence showed the same size of hyperautofluorescent ring as seen preoperatively despite the MH being closed (). The decimal BCVA of the right eye 6 months after the vitrectomy was 0.2.