Work

Acute Macular Hole Formation after Posterior Vitreous Detachment Induction in Epiretinal Membrane Surgery: A Case Report

Year: 2026

Type: article

Abstract: Introduction: We report a case of acute macular hole (MH) formation that occurred immediately following posterior vitreous detachment (PVD) induction during epiretinal membrane (ERM) surgery, and to highlight the significance of intraoperative foveal hemorrhage as an early indicator of this complication. Case Presentation: A 47-year-old Asian female presented with blurred vision in the left eye. Preoperative examination revealed an ERM with associated macular distortion. The patient underwent cataract surgery combined with pars plana vitrectomy, including induction of PVD, ERM, and internal limiting membrane peeling. A small foveal hemorrhage was noted immediately after PVD induction. On postoperative day 1, OCT revealed a full-thickness MH with foveal hyperreflective lesion and posterior shadowing, consistent with foveal hemorrhage. Despite in-office intravitreal gas injection, the MH persisted and required a second vitrectomy with additional gas tamponade. Follow-up OCT confirmed successful closure of the MH, with gradual restoration of the photoreceptor and outer plexiform layers. Conclusion: Acute MH formation can occur immediately after PVD induction during ERM surgery, even in the absence of overt vitreomacular traction or direct macular trauma. Intraoperative foveal hemorrhage should alert the surgeon to the possibility of impending MH formation.

Source: Case Reports in Ophthalmology

DOI: 10.1159/000550899

Author: Jun Young Park

Institutions: Eulji University, Eulji University Uijeongbu Eulji Medical Center

Language: English

Topic: Retinal and Macular Surgery

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,030