Spontaneous closure of bilateral full thickness macular holes without surgery: an eleven-year follow-up.

PURPOSE AND METHOD: To present a 60-year-old woman affected by bilateral full thickness macular hole, showing without surgery a spontaneous resolution of the disease in both eyes that remains unchanged during an eleven-year follow-up. To our knowledge, this clinical case is uncommon as no similar reports with such a long follow-up have been published in the scientific literature at this time. RESULTS AND CONCLUSIONS: A spontaneous and bilateral closure of full thickness macular holes was detected, as a consequence of a complete posterior vitreous detachment documented by optical coherence tomography images. An initial reduction up to a complete resolution of the central macular scotoma was also observed by performing scanning laser ophthalmoscope microperimetry. Both these anatomical and functional results did not change during the whole period of follow-up. According to this study, the release or the weakening of the vitreous tractions at the foveal edges seems to play a key role in the spontaneous resolution of macular holes in not surgically treated patients.