gms | German Medical Science

An idiopathic macular hole presents a retina defect in the place of acute vision, which is characterized with dislocation of neurosensory retina with abolishment of pigment epithelium receptor layer. As a result, due to fixation damage, the central detailed visual acuity of the affected eye is significantly decreased. According to Gass, there are four different Stages I–IV of macula hole. The surgery is reasonably performed by Stages II till IV. We reported about a 77 years old male patient who was for the first time in our clinic in September 2008 examined with the complains of Metamorphopsien and a brown spot on the left eye. A month ago he received intravitreal treatment on the left eye with Lucentis because of retina edema and intra-retinal cystoid spots. In october 2008 with the help of OCT was observed a macular hole developed in Stage II–IV with retraction of vitreous’ boundary surface. In the same time the diagnosed visual acuity was 0.3. That was the reason a vitrectomy with the thrombocyteconcentrate and gastamponade to be recommended. Four weeks later, during the preoperative examination, the macula hole had closed, the visual acuity was increased to 0.5. We performed a follow up. The situation was stable,we decided only to control, without perform any surgery. After regular observations in a time span of five months the macula hole was not detectible and the fixation was central again.