Spontaneous Closure of a Macular Hole Caused by a Ruptured Retinal Arterial Macroaneurysm

Abstract

Purpose

To report a spontaneous closure of a macular hole (MH) that was caused by a ruptured retinal arterial macroaneurysm (RAM).

Methods

Observational case report. Clinical examinations and optical coherence tomographic (OCT) evaluations of the retina of a 73-year-old woman who developed a MH secondary to a ruptured RAM.

Results

The first sign of a closure of the MH was the appearance of tissue bridging the MH in the OCT images. Later, OCT images showed a hyperreflective tissue, probably glial cells, that connected the bridging tissue to the RPE. Seven months after the first examination, the hyperreflective tissue was smaller and the shape of the foveal pit had recovered.

Conclusions

A spontaneous closure of a MH caused by a ruptured RAM can occur and surgical intervention was not necessary. The tissue bridging over the MH and the hyperreflective tissue connecting the bridging tissue to the RPE most likely were involved in the spontaneous MH closure.