Topical carbonic anhydrase inhibitors closing bilateral secondary macular holes and a review of literature.

ABSTRACT

PURPOSE: To present a rare occurrence of bilateral macular hole secondary to vitrectomy that was successfully treated with topical carbonic anhydrase inhibitors and to review the literature for this phenomenon. METHODS: Monthly clinical examination and optical coherence tomography (OCT) was conducted before and after eight weeks of topical 2% dorzolamide administered twice a day. RESULTS: A 62-year-old male that had bilateral giant retinal tears which were repaired with vitrectomy subsequently presented with bilateral small macular holes of size 74 and 78 microns. Patient was trialled on 2% topical dorzolamide twice a day and reviewed monthly with OCT scans. Macular hole closure was identified after four weeks of topical treatment. Conclusion: Clinical improvement with conservative measures suggests a potential first line approach to the treatment of macular holes avoiding surgery and its risk profile. We also present a review of literature regarding macular holes treated with topical carbonic anhydrase inhibitors and its mechanism of action in treating macular holes.