Full-Thickness Macular Hole with Coats Disease: A Case Report

Abstract

We report a case of full-thickness macular hole (FTMH) which developed during follow-up for Coats disease. To our knowledge, this is the first report on a case of FTMH which developed during follow-up for Coats disease. A 17-year-old boy was referred to our institution with blurred vision in his left eye. Fundus examination showed yellowish subretinal exudates with overlying telangiectatic retinal vessels in the temporal periphery in the left eye; the right eye was normal. Fluorescein angiography revealed diffusion indicative of temporal peripheral vascular leakage. We made a diagnosis of stage 2A Coats disease and performed argon laser photocoagulation (PC). Moreover, he received intravitreal injection of anti-vascular endothelial growth factor. At 30 months after the first visit, the best-corrected visual acuity (BCVA) of the left eye worsened to 20/50. We observed tensioned internal limiting membrane (ILM), serous macular detachment (SMD) and retinal thinning; the intraretinal exudate remained. We performed PC and at 36 months after the first visit, BCVA further declined to 20/63 in his left eye and FTMH was observed. We then performed a 27-gauge pars plana vitrectomy and ILM peeling following which the FTMH was found to have closed by 4 days after vitrectomy. SMD gradually decreased, and BCVA improved to 20/20. Chronic inflammation by peripheral vascular leakage and PC application might have caused FTMH. In this case, the vitrectomy for FTMH with Coats disease provided good visual and anatomic outcomes.

Full-Thickness Macular Hole in Coats Disease Treated Using the Inverted Internal Limiting Flap Technique

“…The final visual acuity (VA) was 20/80. Hashimoto et al 7 presented the only case with early closure as well as excellent final VA (20/20).…”

“…In PubMed Medline we found only 7 case reports describing this phenomenon. [1][2][3][4][5][6][7] Some cases were reported before the availability of optical coherence tomography (OCT), and only 3 described surgical treatment. 3,4 Wong et al 4 reported 2 failed attempts to close a macular hole in a child with Coats disease.…”

“…In PubMed Medline we found only 7 case reports describing this phenomenon. 1–7 Some cases were reported before the availability of optical coherence tomography (OCT), and only 3 described surgical treatment. 3,4…”