Idiopathic macular hole : unusual cause of vision loss

Abstract

We report the case of 60 years old woman who present blurred vision in both eyes. The Best corrected visual acuities were 2 /10. Dilated fundus examination suspected macular hole in both eyes. The Optical Coherence Tomography (OCT) confirmed the diagnosis of bilateral macular hole stage 1 (A: right eye, B : left eye). A macular hole is a disruption of the center of the macula. As humans age, the vitreous begins to shrink. His deterioration causes it to pull on the macula. In most cases, the vitreous separates without any negative side effects. However, in some cases where the vitreous is firmly attached to the central area of the retina, this pulling away may form a small hole, known as a macular hole. Macular holes can be seen in highly myopic eyes, or following ocular trauma, but the great majority are idiopathic. Idiopathic macular hole is a retinal disease affecting elderly people, especially women. Symptoms with impending macular holes include decreased vision and metamorphopsia. The diagnosis and classification is based on the OCT. The treatment for early full thickness macular holes is vitrectomy surgery, rather than observation. We remove the vitreous gel that is pulling on the macula. Then, the eye is filled with a special gas bubble to help flatten the macular hole and hold it in place while it heals.

Keywords

• idiopathic macular hole
• vision loss
• visual acuity