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Spontaneous Closure of a Full-Thickness Macular Hole With Conversion to Exudative Age-Related Macular Degeneration

Daniel Su, MD1; Michael A. Klufas, MD1; Jean-Pierre Hubschman, MD1
[+] Author Affiliations
1Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
JAMA Ophthalmol. 2016;134(5):604-606. doi:10.1001/jamaophthalmol.2016.0020.
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This case report describes spontaneous closure of a full-thickness macular hole after conversion from nonexudative to exudative age-related macular degeneration.

Macular hole formation is thought to occur secondary to anteroposterior forces and traction at the vitreofoveal interface. Although it is uncommon, there have been numerous reports of spontaneous closures of macular holes.1,2 These closures are triggered by the release of anterior traction at the vitreofoveal interface or glial proliferation from retinal or epiretinal tissue. We report a case of spontaneous closure of a full-thickness macular hole (FTMH) after conversion from nonexudative to exudative age-related macular degeneration (AMD).

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Figure 1.
Optical Coherence Tomography Results Before Conversion From Nonexudative to Exudative Age-Related Macular Degeneration

A, Spectral domain optical coherence tomography of the left eye 3 years before presentation showed a full-thickness macular hole (FTMH) with no vitreous adhesions or traction. B, On presentation, the FTMH was stable, with a new serous pigment epithelial detachment but no visible neovascular lesion.

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Figure 2.
Multimodal Imaging Results After Conversion From Nonexudative to Exudative AMD

A, Optical coherence tomography (OCT) showing spontaneous closure of the full-thickness macular hole (FTMH), with progression to exudative age-related macular degeneration (AMD). B, Corresponding fluorescein angiogram showing early hyperfluorescence consistent with the type 2 lesion in part A. C, Late leakage obscuring the boundary of the lesion. D, Results of OCT after 3 monthly injections of bevacizumab.

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