Published in:
Open Access
01-12-2020 | Edema | Case report
Two cases of diabetic macular edema complicated by an atypical macular hole
Authors:
Yuich Yoshida, Takaki Sato, Shou Oosuka, Masashi Mimura, Masanori Fukumoto, Takatoshi Kobayashi, Teruyo Kida, Tsunehiko Ikeda
Published in:
BMC Ophthalmology
|
Issue 1/2020
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Abstract
Background
Here we report two patients who developed an atypical macular hole (MH) during the treatment course for diabetic macular edema (DME).
Case presentations
Patient 1 was a 73-year-old male. Optical coherence tomography (OCT) revealed perifoveal retinoschisis (RS) in addition to cystoid macular edema and serous retinal detachment (SRD) in his left eye, and that an MH had developed during the clinical course. A convex surface was formed at the MH margin toward the vitreous cavity, and granular shadows were observed in the fluid cuff. Intraoperative findings revealed a thin epiretinal macular membrane (ERM) around the MH. Patient 2 was a 79-year-old male. Although the patient underwent pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) in both eyes, RS and a thin ERM in addition to SRD was observed in his left eye after surgery, and an MH developed during the clinical course. As in Patient 1, a convex surface was formed at the fluid cuff margin toward the vitreous cavity.
Conclusions
Both patients had persistent DME, SRD, RS, and a thin ERM before the development of the MH. OCT revealed the formation of a convex surface at the MH margin toward the vitreous cavity, suggesting that the fragility of the layered structure of the retina combined with tangential retinal traction may have been involved in the atypical MH form.