Rapid and spontaneous resolution of hemorrhagic macular hole retinal detachment and subretinal hemorrhages in an eye wit
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CASE REPORT
Open Access
Rapid and spontaneous resolution of hemorrhagic macular hole retinal detachment and subretinal hemorrhages in an eye with pathologic myopia: a case report Taiju Ito1,2, Tae Igarashi-Yokoi1* , Kosei Shinohara1,3, Takeshi Yoshida1 and Kyoko Ohno-Matsui1
Abstract Background: To report a rare case of pathologic myopia in which a choroidal neovascularization (CNV) induced a hemorrhagic macular hole retinal detachment (MHRD), and then both the CNV and MHRD disappeared simultaneously in 5 days. Case presentation: A 76-year-old man with pathologic myopia complained of distorted vision in his left eye of 1week duration. The visual acuity in the left eye was 20/20 and the axial length was 31.0 mm. Ophthalmoscopic examinations of the left eye showed many retinal hemorrhages and whitish lesions on a background of severe diffuse myopic atrophy. Swept-source OCT (SS-OCT) showed multiple hyperreflective vertical finger-like projections extending into the outer retina that corresponded to the area of the botryoidal-shaped retinal hemorrhages. The SS-OCT images also showed many subretinal infiltrations adjacent to linear retinal hemorrhages with a disruption of the adjacent ellipsoid zone of the photoreceptors. Fluorescein angiography (FA) showed early hyperfluorescence and late leakages corresponding to the areas of the hemorrhages or adjacent to the linear retinal hemorrhages. These results suggested that the development of the inflammatory CNV was related to the outer retinopathy or choroiditis as in eyes with punctate inner choroidopathy or multifocal choroiditis rather than myopic CNV. We planned an intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection but the patient noticed a sudden reduction of the visual acuity a few days before the anti-VEGF injection. The left fundus showed a MHRD due to the subretinal hemorrhage. Five days later, the SS-OCT images confirmed a recession of the CNV and a resolution of the MHRD. Conclusions: Rapid and spontaneous resolution of both myopic CNV and hemorrhagic MHRD suggest that there may have been a mutual mechanism causing the MHRD and CNV. A careful follow-up before doing surgery may be a choice for hemorrhagic MHRD in eyes with pathologic myopia. Keywords: Pathologic myopia, Macular hole retinal detachment, Choroidal neovascularization, Punctate inner choroidopathy, Multifocal choroiditis * Correspondence: [email protected] 1 Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes we
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