Closure of macular hole secondary to ischemic hemi-central retinal vein occlusion by retinal photocoagulation and topica
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LETTER TO THE EDITOR
Closure of macular hole secondary to ischemic hemi-central retinal vein occlusion by retinal photocoagulation and topical anti-inflammatory treatment Teru Asato 1 & Norihiro Nagai 1,2 & Misa Suzuki 1,2 & Atsuro Uchida 1 & Toshihide Kurihara 1 & Norimitsu Ban 1 & Sakiko Minami 1 & Hajime Shinoda 1 & Kazuo Tsubota 1 & Yoko Ozawa 1,2,3,4 Received: 6 July 2020 / Accepted: 18 August 2020 # The Author(s) 2020
To the Editor: We report a case of full-thickness macular hole (MH) secondary to hemi-central retinal vein occlusion (CRVO) that was closed after retinal photocoagulation to the nonperfusion area (NPA) and anti-inflammatory treatment by topical bromfenac sodium hydrate. In July 2019, a 72-year-old Japanese man was referred to the Medical Retina Division of Keio University Hospital (Tokyo, Japan) due to blurred vision in his right eye for 6 months. He had a history of unilateral nephrectomy. He had hemi-CRVO (Fig. 1a) and a full-thickness MH (Fig. 1a–c) with posterior vitreous detachment in his right eye. The optical coherence tomography (OCT) image showed epiretinal membrane (ERM) (Fig. 1b, c white arrowheads) and lamellar holeassociated epiretinal proliferation (LHEP)-like material (Fig. 1b yellow arrowheads) around the MH edge. His bestcorrected visual acuity (BCVA) was 0.15 (0.823 LogMAR). Fluorescein angiography (FA) showed extensive NPA and vascular leakage in the affected area (Fig. 1d); he was diagnosed with ischemic hemi-CRVO and underwent retinal photocoagulation to prevent neovascularization. Topical bromfenac sodium hydrate was prescribed and continued
Teru Asato and Norihiro Nagai contributed equally to this work. * Yoko Ozawa [email protected]; [email protected] 1
Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
2
Laboratory of Retinal Cell Biology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
3
Department of Ophthalmology, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
4
St. Luke’s International University, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
throughout the course to reduce retinal vein occlusion (RVO)-related inflammation and photocoagulation-related transient inflammation [1]. In August 2019, a tiny bridging element appeared between the MH edges in the OCT image (Fig. 1e arrow); his BCVA improved slightly to 0.3 (0.523 LogMAR). In September 2019, the bridging element thickened and an external limiting membrane (ELM) was formed (Fig. 1f arrow); his BCVA improved to 0.7 (0.155 LogMAR). In November 2019, the ellipsoid zone recovered, and the MH closed (Fig. 1g, h); his BCVA recovered to 0.8 (0.100 LogMAR). Laser scars were evident in the NPA (Fig. 1g arrowheads). MH is generally formed by tractional forces at the vitreoretinal interface and treated by surgical removal of these forces; pars plana vitrectomy is typically used. Although the affected eye had secondary ERM, which may have caused tractional forces, and LHEP-
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