Hyperautofluorescent ring in eyes with macular holes
A 69-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 13 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 1.0 in the left eye. The minimal and maximal diameter of the MH were 681 μm and 1,555 μm, respectively ( and ). Optical coherence tomography showed disruptions of the photoreceptor inner and outer segment junction (IS/OS) line and the external limiting membrane line at the edge of the cuff of subretinal fluid (). A depigmented ring was seen surrounding the area of the fluid cuff, and fundus autofluorescence showed a hyperautofluorescent ring corresponding to the depigmented ring ( and ).\nCombined phacoemulsification and vitrectomy was performed with a 25-gauge ultrahigh-speed cutter on the right eye under local anesthesia. After core vitrectomy followed by the creation of posterior vitreous detachment, peripheral vitrectomy and 360 degree vitreous shaving with scleral indentation was performed. The internal limiting membrane within the vascular arcade was peeled assisted by Brilliant Blue G staining. The vitreous cavity was filled with 12% perfluoropropane. She was instructed to maintain a prone position for as long as possible.\nThe MH was anatomically closed but the optical coherence tomography images did not show any recovery of the IS/OS line or the external limiting membrane line 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.