E

Case 3-3 continued

Follow-up

Six months after initial presentation, the patient returned with a decrease in visual acuity in her left eye from 20/20 to 20/80. A small neurosensory foveal detachment was identified (F) consistent with a late Stage lb hole.

Follow-up Optical Coherence Tomography

A vertical OCT image (G) showed flattening of the foveal contour and a non-reflective intra retinal space without a full-thickness retinal dehiscence. The posterior hyaloid was visible superior to the fovea as a lightly reflective membrane separated from the retina. The membrane appeared to exert traction on an attached operculum which was slightly elevated compared to the surrounding inner limiting membrane-

Inferior

Superior

540 |jm

540 |jm

Log Reflection

250 pm

Log Reflection

Case 3-3 continued

Follow-up

One month later, the visual acuity in the patient's right eye remained at 20/80. Dilated fundus examination (H) revealed progression to an early Stage 2 hole.

Follow-up Optical Coherence Tomography

OCT (I) demonstrated the development of a full-thickness retinal dehiscence with a partially attached operculum consistent with a Stage 2 classification. Cystic changes and increased retinal swelling were noted surrounding the hole. The posterior hyaloid membrane was not visible in the image.

This sequence of OCT images (E,G,I) demonstrates the development of a full-thickness macular hole from an initial perifoveal vitreous detachment with fovea 1 adhesion.

Reverse Testicular Atrophy

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