Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge
We describe the diagnostic and therapeutic strategies employed in the management of a patient with subfoveal pigment epithelial detachments (PEDs) combined with full-thickness macular hole (FTMH) and discuss the possible pathophysiology of these diseases occurring concurrently. A 38-year-old patient...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Oman Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ojoonline.org/article.asp?issn=0974-620X;year=2023;volume=16;issue=2;spage=336;epage=341;aulast=Manayath |
| _version_ | 1827894634669408256 |
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| author | George J Manayath Sreelakshmi P Amar Swapnil Shivaji Vidhate Karan A Kumarswamy Narendran Venkatapathy |
| author_facet | George J Manayath Sreelakshmi P Amar Swapnil Shivaji Vidhate Karan A Kumarswamy Narendran Venkatapathy |
| author_sort | George J Manayath |
| collection | DOAJ |
| description | We describe the diagnostic and therapeutic strategies employed in the management of a patient with subfoveal pigment epithelial detachments (PEDs) combined with full-thickness macular hole (FTMH) and discuss the possible pathophysiology of these diseases occurring concurrently. A 38-year-old patient with a history of central serous chorioretinopathy (CSC) presented with FTMH overlying a large subfoveal serous PED. Multimodal imaging confirmed the same and intravitreal anti-vascular endothelial growth factor (VEGF) injections and eplerenone failed to resolve the PED. Spontaneous resolution of the large PED was observed later and pars plana vitrectomy with internal limiting membrane peeling closed the macular hole successfully. However, the PED with fibrinous CSC recurred postoperatively and low fluence photodynamic therapy (PDT) was done to tackle the same. At 10 months' follow-up, the final vision was 6/9, the macular hole remained closed, and the PED had not recurred. Macular hole formation may be the result of choroidal hyperpermeability and leakage in the backdrop of CSC which gives rise to an exudative component causing mechanical stretching and disruption of the overlying sensory retina. Spontaneous uncomplicated resolution of large subfoveal PED in CSCR is rare. This case was managed with a combination of intravitreal anti-VEGF injections, surgery, and PDT. The therapeutic challenge here was the timing of surgery. |
| first_indexed | 2024-03-12T22:09:27Z |
| format | Article |
| id | doaj.art-d9f19c42c5d140c1aa93bc16dd95bf85 |
| institution | Directory Open Access Journal |
| issn | 0974-620X |
| language | English |
| last_indexed | 2024-03-12T22:09:27Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Oman Journal of Ophthalmology |
| spelling | doaj.art-d9f19c42c5d140c1aa93bc16dd95bf852023-07-23T16:12:46ZengWolters Kluwer Medknow PublicationsOman Journal of Ophthalmology0974-620X2023-01-0116233634110.4103/ojo.ojo_261_22Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challengeGeorge J ManayathSreelakshmi P AmarSwapnil Shivaji VidhateKaran A KumarswamyNarendran VenkatapathyWe describe the diagnostic and therapeutic strategies employed in the management of a patient with subfoveal pigment epithelial detachments (PEDs) combined with full-thickness macular hole (FTMH) and discuss the possible pathophysiology of these diseases occurring concurrently. A 38-year-old patient with a history of central serous chorioretinopathy (CSC) presented with FTMH overlying a large subfoveal serous PED. Multimodal imaging confirmed the same and intravitreal anti-vascular endothelial growth factor (VEGF) injections and eplerenone failed to resolve the PED. Spontaneous resolution of the large PED was observed later and pars plana vitrectomy with internal limiting membrane peeling closed the macular hole successfully. However, the PED with fibrinous CSC recurred postoperatively and low fluence photodynamic therapy (PDT) was done to tackle the same. At 10 months' follow-up, the final vision was 6/9, the macular hole remained closed, and the PED had not recurred. Macular hole formation may be the result of choroidal hyperpermeability and leakage in the backdrop of CSC which gives rise to an exudative component causing mechanical stretching and disruption of the overlying sensory retina. Spontaneous uncomplicated resolution of large subfoveal PED in CSCR is rare. This case was managed with a combination of intravitreal anti-VEGF injections, surgery, and PDT. The therapeutic challenge here was the timing of surgery.http://www.ojoonline.org/article.asp?issn=0974-620X;year=2023;volume=16;issue=2;spage=336;epage=341;aulast=Manayathcentral serous choroidopathymacular holepigment epithelial detachment |
| spellingShingle | George J Manayath Sreelakshmi P Amar Swapnil Shivaji Vidhate Karan A Kumarswamy Narendran Venkatapathy Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge Oman Journal of Ophthalmology central serous choroidopathy macular hole pigment epithelial detachment |
| title | Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge |
| title_full | Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge |
| title_fullStr | Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge |
| title_full_unstemmed | Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge |
| title_short | Full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy: A therapeutic challenge |
| title_sort | full thickness macular hole with subfoveal pigment epithelial detachment in chronic central serous chorioretinopathy a therapeutic challenge |
| topic | central serous choroidopathy macular hole pigment epithelial detachment |
| url | http://www.ojoonline.org/article.asp?issn=0974-620X;year=2023;volume=16;issue=2;spage=336;epage=341;aulast=Manayath |
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