|Year : 2020 | Volume
| Issue : 9 | Page : 1941-1942
Giant macular hole in a case of multifocal choroiditis
Tejaswini Vukkadala, Sudip Mondal, Shorya Vardhan Azad, Vinod Kumar
Vitreoretina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
|Date of Submission||07-May-2020|
|Date of Acceptance||28-Jun-2020|
|Date of Web Publication||20-Aug-2020|
Dr. Vinod Kumar
Vitreoretina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
Keywords: Choroiditis, giant macular hole, macula
|How to cite this article:|
Vukkadala T, Mondal S, Azad SV, Kumar V. Giant macular hole in a case of multifocal choroiditis. Indian J Ophthalmol 2020;68:1941-2
|How to cite this URL:|
Vukkadala T, Mondal S, Azad SV, Kumar V. Giant macular hole in a case of multifocal choroiditis. Indian J Ophthalmol [serial online] 2020 [cited 2020 Sep 23];68:1941-2. Available from: http://www.ijo.in/text.asp?2020/68/9/1941/292526
A 60-year-old female presented with diminution of vision OU for 10 years. She had frequent episodes of recurrent blurring of vision in the past. There was no history of trauma. Vision was hand movement OD and 1/60 OS. Slit-lamp examination showed no anterior chamber reaction with grade 1 senile cataract. Fundus revealed OU healed multifocal choroiditis. In addition, extensive chorioretinal atrophy involving the posterior pole in OD and a giant full thickness macular hole [MH] of 1.5 disc-diameters with a central island of retinal tissue was noted in OS [Figure 1]a. Fundus autofluorescence showed hyperautofluorescence corresponding to the MH and hypoautofluorescence corresponding to the healed choroiditis scars [Figure 1]b. Spectral domain Optical Coherence Tomography (SD-OCT) revealed a minimum hole diameter of 2327 microns and an island of retinal tissue in the center [Figure 1]c. The patient denied surgery in view of poor prognosis.
|Figure 1: Colour fundus photograph (a) of left eye shows multiple healed choroiditis patches and a large macular hole with spared retinal tissue at centre (red arrow). White arrows depict the direction of the OCT scan. Autofluorescence shows hyperautofluorescence corresponding to the MH and hypoautofluorescence corresponding to the healed choroiditis scars (b). SD-OCT (c) shows large full thickness macular hole with with spared retinal tissue at centre (red arrow)|
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| Discussion|| |
Large macular holes with minimum hole diameter more than 1500 microns are categorized as giant macular holes. Giant macular holes have been reported in the setting of Alport syndrome and following trauma., Features of Alport syndrome including renal failure, sensorineural deafness, and characteristic retinopathy were not present in our case. Probable mechanisms of MH formation in the setting of inflammation include epiretinal membranes of inflammatory origin, repeated vitritis with irregular contraction of premacular vitreous, centrifugal photoreceptor displacement by tangential vitreous traction, and persistent cystoid macular edema.[4.5] Foci of chorioretinitis further make the retinal layers fragile contributing to the formation of MH.
To conclude, we report the occurrence of a giant macular hole in a patient with multifocal choroiditis.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s)/ guardian has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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