| Full Thickness Macular Hole Associated with Rupture of Retinal Arterial Macroaneurysm |
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Han Min Lee, Sung Bok Lee, Jung Yeul Kim, Young Joon Jo |
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Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea |
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Received: 17 April 2015 • Revised: 2 June 2015 • Accepted: 3 June 2015 |
| Abstract |
Purpose: To report a case of full thickness macular hole associated with rupture of retinal arterial macroaneurysm.
Case summary: A 84-year-old female presented with 1-week history of decreased vision in the left eye. She had poorly controlled hypertension. On the initial examination, the best corrective visual acuity (BCVA) was 0.8 in the right eye and finger count 30 cm in the left eye. Both eyes had nucleoscleosis and cortical opacity. A fundus examination detected a sub-internal limiting membrane (ILM) premacular hemorrhage and small vitreous hemorrhage with a subretinal hemorrhage. Fluorescein angiography and indocyanine green angiography revealed a hot spot of retinal arterial macroaneurysm at superotemporal branch retinal artery. Hourglass patterned hemorrhage related with retinal arterial macroaneurysm was diagnosed. 23 gauge vitrectomy was performed to remove sub-ILM hemorrhage and if needed and possible, removal of subretinal hemorrhage was planned. After core vitrectomy, sub-ILM hemorrhage was confirmed, and partial ILM peeling was done. After removal of sub-ILM hemorrhage, full thickness macular hole was observed. More ILM was peeled, fluid gas exchange was done. Anatomic closure of the macular hole was achieved after the operation and was confirmed by optical coherence tomography examination. Two months after surgery, her vision had improved to 0.3.
Conclusions: Macular hole which found during surgery was associated with rupture of retinal arterial macroaneurysm. A full-thickness macular hole occurred at the same time as retinal arterial macroaneurysm ruptured. Early surgery should be considered for retinal arterial macroaneurysm casuing all layers retinal hemorrhages need early surgery.
Ann Optom Contact Lens 2015;14(2):107-110 |
| Key Words:
Macular hole, Retinal arterial macroaneurysm |
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