Selma URFALIOGLU, Mete GÜLER, İsmail EVGİN

Koroid Neovasküler Membranlı Bir Hastada Maküla Deliğinin Spontan Kapanması

Tam kalınlıkta makula deliğin kendiliğinden kapanması nadir bir olaydır ve genellikle cerrahi gerekir. 71 yaşında kadın hasta, yaşa bağlı makula dejenerasyonu (YBMD) tanısı ile takip edilmekteydi. Dört yıl önce ani görme düşüşünden şikayet etmişti. Görme keskinlikleri sağ ve sol gözde sırasıyla 0.05 ve 1.0 idi. Optik koherens tomografi muayenesinde sağ gözünde tam kalınlıkta makula deliği ve kuru tip YBMD saptandı. İzlem sırasında kuru tip YBMD'nin yaş tipe değiştiği ve koroid neovasküler membran(KNVM)'ın geliştiği belirlendi. Makula deliği kendiliğinden kapanmış ve aktif KNVM ve epiretinal membrana rağmen görme keskinliği artmıştı. Koroid neovasküler membran maküler deliğin kapanmasını kolaylaştırabilir ve ameliyattan önce kendiliğinden kapanma için gözlem bu iki kombine patolojiye sahip hastalar için bir seçenek olabilir.

Anahtar Kelimeler:

koroid neovasküler membran, maküler delik, optik koherehs tomografi

Spontaneous Closure of Macular Hole in A Patient with ChoroidalNeovascular Membrane

Spontaneous closure of a full thickness macular holeis a rare event and usually surgery is needed. A 71 year-old-woman had been followed with the diagnosis of age related macular degeneration (AMD). Four years ago she had complained with sudden vision drop. Visual acuities were 0.05 and 1.0 in right and in left eyes, respectively. On optical coherence tomography examination full thickness macular hole and dry type AMD were detected in her right eye. During follow up it was determined that dry type AMD had changed to wet form and choroidalneovascular membrane (CNVM) had developed. The macular hole had spontenously closed and visual acuity increased despite active CNVM and epiretinal membrane.Choroidalneovascular membrane may facilitate macular hole closure and observation for spontenous closure before surgery may be an option for patients that have these two combined pathologies.

Keywords:

choroidal neovascular membrane, macular hole, optical cohorence tomography,

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1- Bikbova G, Oshitari T, Baba T, Yamamoto S, Mori K. Pathogenesis and Management of Macular Hole: Review of Current Advances. J Ophthalmol. 2019;2019:3467381.
2 Bhojwani D, Vasavada S, Sudhalkar A, Vasavada V, Vasavada AR. Acute full-thickness macular hole after uneventful femtosecond-assisted cataract surgery and its spontaneous closure. Indian J Ophthalmol. 2018;66(6):848‐849.
3- Nalcı H, Batıoğlu F, Demirel S, Özmert E. Spontaneous closure of macular hole in a patient with macular telangiectasia type 2. Retin Cases Brief Rep. 2018. doi:10.1097/ICB.0000000000000812.
4- Cohen MN, Baumal CR. Macular hole formation followed by spontaneous closure after pneumatic retinopexy in a patient with diabetic macular edema [published online ahead of print, 2018 May 10]. Retin Cases Brief Rep. 2018.doi:10.1097/ICB.0000000000000744.
5- Su D, Klufas MA, Hubschman JP. Spontaneous Closure of a Full-Thickness Macular Hole With Conversion to Exudative Age-Related Macular Degeneration. JAMA Ophthalmol. 2016;134(5):604‐606.
6- Lee J, Nguyen VQ, Doss MK, Eller AW. Spontaneous closure of a chronic full thickness macular hole after failed surgery. Am J Ophthalmol Case Rep. 2018;13:59‐61.
7- Figueroa MS, Govetto A, Arriba-Palomero Pd. Short-term results of platelet-rich plasma as adjuvant to 23-G vitrectomy in the treatment of high myopic macular holes. Eur J Ophthalmol. 2016;26(5):491‐496.