RETINA PHOTO_Janusz Michalewski

We illustrate the case of a 76-year-old woman with rhegmatogenous retinal detachment (RRD) and coexisting full-thickness macular hole (FTMH). On admission, the patient presented counting fingers vision in her left eye. Fundus evaluation revealed RRD with peripheral tear, involving three quadrants of the retina and the macula. Spectral Domain optical coherence tomography (SD-OCT) confirmed FTMH (Figure 1a, b). Scleral buckling surgery with gas injection for RRD was performed and the retina was reattached. Vision improved to 0.05 after 14 weeks, and, surprisingly, the SD-OCT examination additionally revealed closure of the FTMH (Figure 2 a, b). The FTMH remained closed 13 months after surgery and the fovea contour improved with time (Figure 3 a, b). Final visual acuity was 0.1. RRD coexisting with a FTMH in emmetropic subjects is uncommon and retinal specialists believe that in those rare cases peripheral breaks should be located and treated first. If the detachment persists, the FTMH must be treated.1 Closure of FTMH during vitrectomy was discussed as being due to relieving of anteroposterior traction during removal of vitreous and due to relieving of tangential traction when internal limiting membrane (ILM) is peeled. ILM peeling may also induce gliosis, which is another factor enabling closure.2 Moreover, RRD itself is also factor inducing gliosis.3 In our case, the mechanism of FTMH closure, established by SD-OCT scans, remains unknown. Our photo essay demonstrates an interesting and rare case of RRD coexisting with FTMH. To the best of our knowledge, there are no other SD-OCT documented reports on closure of a FTMH after treatment of RRD that did not solely concern the macula.