Spontaneous resolution of parafoveal macular hole post YAG hyaloidotomy in a case of Valsalva retinopathy

Abstract

Purpose To report a rare case of spontaneous resolution of parafoveal macular hole post YAG hyaloidotomy in case of Valsalva retinopathy. Methods Case Report. Results A 29-year-old female presenting with sudden diminution of vision in her left eye (LE) for two months following a bout of vomiting was diagnosed with pre-macular haemorrhage. Patient was planned for YAG hyaloidotomy on the same day followed by propped up positioning. On follow up haemorrhage was seen to be cleared around macula with corresponding improvement of visual acuity. Patient was found to have developed a parafoveal hole post procedure which spontaneously healed without any intervention. Visual acuity was subsequently improved with resolution of macular hole as seen on fundus imaging and Optical coherence tomography (OCT). Conclusion Pre-macular haemorrhage is quite common phenomenon in Valsalva retinopathy cases and YAG hyaloidotomy is an established surgical modality for management of the same in literature with good clinical outcomes. However, formation of macular hole is not very common but described in literature post procedure. It is a rare phenomenon to have spontaneous resolution of macular hole. Hence, observation can be an option for managing such cases.