Development of a full thickness macular hole after vitrectomy for rhegmatogenous retinal detachment: a sequential study via optical coherence tomography

BACKGROUND: To demonstrate a full thickness macular hole (MH) development after vitrectomy (VT) for rhegmatogenous retinal detachment (RRD) and to investigate the possible disease mechanism with optical coherence tomography (OCT). CASE PRESENTATION: A 47-year-old female underwent 23G vitrectomy surgery to repair the macula-detached RRD successfully. However, intraretinal cysts initially developed two months after surgery. Cysts gradually increased in number and size, and cystoid macular edema was noted at the 5th month. Thereafter, inner retina dehiscence and a lamellar macular hole developed. The lamellar hole further dehisced and progressed into a full-thickness MH at the 10th month. The patient then received 23G vitrectomy and internal limiting membrane peeling surgery. OCT and fundus picture showed macular hole sealed 10 days afterward. CONCLUSIONS: The mechanism of secondary MH included tangential traction, cystoid degeneration of macula, and glial migration. The sequential OCT studies provide evidence to support the disease mechanism of cystoid degeneration of the macula.