Spontaneous closure and quick reopening of a full thickness idiopathic macular hole

Purpose: To report a quick reopening of a spontaneously closed full thickness macular hole. Design: Case report. Methods: A 68-year-old patient with stage III full thickness idiopathic macular hole in one eye was followed up for thirteen months with fundus photography and optical coherence tomography (OCT). Results: Twelve days after the first examination, that detected the macular hole, OCT scans revealed the closure of the macular hole associated to the development of a small epiretinal membrane (ERM). One month later, the patient was admitted to the emergency unit, complaining of progressive visual loss over the past three days. OCT examination showed a full-thickness macular hole, very similar to the previously closed, and a progression of the ERM. The patient was submitted to pars plana vitrectomy with internal limiting membrane peeling and removal of ERM. Surgical repair resulted in significant functional and anatomic outcome. Conclusion: The reopening of a spontaneously closed macular hole is remarkably uncommon and has been reported previously in two patients. A rigorous follow-up is mandatory, because these macular holes can quickly reopen, as demonstrated in this case report.