Vitrectomy with residual internal limiting membrane covering and autologous blood for a secondary macular hole: A case report

doi:10.12998/wjcc.v10.i2.671

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Jan 14, 2022; 10(2): 671-676
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.671

Vitrectomy with residual internal limiting membrane covering and autologous blood for a secondary macular hole: A case report

Huang-Fang Ying, Shuang-Qing Wu, Wei-Ping Hu, Li-Yang Ni, Zi-Long Zhang, Yong-Gen Xu

Huang-Fang Ying, Wei-Ping Hu, Li-Yang Ni, Zi-Long Zhang, Yong-Gen Xu, Department of Ophthalmology, Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang Province, China

Shuang-Qing Wu, Department of Ophthalmology, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital, Hangzhou 310003, Zhejiang Province, China

Author contributions: Ying HF wrote the original draft, contributed to manuscript editing; Wu SQ contributed to manuscript review and editing; Hu WP contributed to collecting data; Ni LY contributed to collecting data; Zhang ZL contributed to collecting data; Xu YG was the patient’s surgeon, contributed to manuscript review.

Informed consent statement: Written informed consent was obtained from the patient for publication of this case report.

Conflict-of-interest statement: No potential conflicts of interest relevant to this article are reported.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Yong-Gen Xu, MD, Chief Doctor, Department of Ophthalmology, Affiliated Hospital of Shaoxing University, No. 999 Zhongxing South Road, Yuecheng District, Shaoxing 312000, Zhejiang Province, China. xuyonggensx@163.com

Received: May 17, 2021
Peer-review started: 23 June 2021
First decision: 16 July 2021
Revised: June 15, 2021
Accepted: December 8, 2021
Article in press: December 8, 2021
Published online: January 14, 2022
Processing time: 202 Days and 9 Hours

Abstract

BACKGROUND

Myopic foveoschisis (MF) is a common complication of pathological myopia. A macular hole (MH) usually results from the natural progression of MF and is a common complication of vitrectomy. Vitrectomy combined with residual internal limiting membrane (ILM) covering and autologous blood was effective for closing a secondary MH.

CASE SUMMARY

A 52-year-old woman presented to our clinic with a complaint of blurred vision in the right eye for 7 years. Her best corrected visual acuity (BCVA) was 20/100, axial length was 25.79 mm and standard equivalent refractive error was -10.5 dioptres. Preoperative optical coherence tomography revealed foveoschisis in the right eye. Vitrectomy with fovea-sparing ILM peeling was performed. An MH developed and gradually expanded 5 mo after the initial vitrectomy. Vitrectomy with residual ILM covering and autologous blood was performed. The MH closed 3 wk after the second vitrectomy.

CONCLUSION

Fovea-sparing ILM peeling can provide residual ILM for the treatment of MH secondary to vitrectomy for MF. Vitrectomy combined with residual ILM covering and autologous blood is effective for closing secondary MH and improving BCVA.

Keywords: Vitrectomy; Internal limiting membrane; Autologous blood; Macular hole; Myopic foveoschisis; Case report

Core Tip: A macular hole (MH) is a common complication after vitrectomy for myopic foveoschisis (MF). This report describes a case of an MH secondary to vitrectomy with fovea-sparing internal limiting membrane (ILM) peeling for MF. We found that the repair process of MF may be centripetal, gradually moving from the peripheral retina to the macula. Second vitrectomy with residual ILM covering and autologous blood is effective for closing secondary MH and improving best corrected visual acuity.