Surgery for macular holes associated with unusual concomitant pathologies
A 22-year-old man presented with blurring of vision in the right eye for 1 month. BCVA was 20/800 in the right eye. He had no perception of light in the left eye. Dilated right eye fundus examination demonstrated inferior choroidal coloboma involving the disc with a FTMH at the edge of the coloboma in the uninvolved macula []. The MH was horizontally oval in shape, 625 microns in size with surrounding cuff of subretinal fluid. OCT showed large FTMH with shallow retinal detachment nasal to the hole []. A 20 G vitrectomy with lensectomy was performed. Posterior vitreous detachment was induced from the superior part of the attached retina. Vitreous was an adherent at the edge of coloboma. ILM was stained using trypan blue (0.06%) for contact time of 2 min. ILM peeling was carried out using ILM peeling forceps. Two to three rows of endolaser were applied along the edge of choroidal coloboma as a prophylactic measure considering that the patient has only one functioning eye. Encircling scleral band was secured followed by silicon oil injection. At 2 months and 4 months follow-up, OCT showed flat edges of MH with decreased diameter (type 2 closure) [Figure and ]. At 7 months silicon oil removal was carried out. OCT showed type 1 closure of MH with a thin neuronal tissue bridging across the fovea []. With low-vision aid BCVA was 20/160.