Bilateral Macular Holes in Adult Vitelliform Macular Dystrophy

Abstract

Purpose:

This report describes a case of bilateral macular holes (MHs) in adult vitelliform macular dystrophy (AVMD).

Methods:

A retrospective case report of a patient with AVMD and sequential onset of bilateral MHs is presented.

Results:

Bilateral MHs were observed after vitreomacular traction was identified on optical coherence tomography. Holes in both eyes were repaired with pars plana vitrectomy (PPV) with C₃F₈ (perfluoropropane) gas tamponade; only the right eye underwent internal limiting membrane peeling. In the right eye, 2 PPVs were required for hole closure. In both eyes, long-term atrophy of the retina and retinal pigment epithelium was observed.

Conclusions:

MHs in AVMD may be preceded by vitreomacular traction. Surgical repair with PPV and gas tamponade was successful. Retinal and retinal pigment epithelium atrophy developed postoperatively, but the patient’s vision still improved.