case_images: PMC10601871_01
case_images: Optical coherence tomography (OCT) of the macular hole (a) and color fundus photo of the fundus prior to both ART procedures (b).
case_images: cop-2023-0014-0001-534142_F01.jpg
case_images: PMC10601871_01_cop-2023-0014-0001-534142_F01.jpg
case_images: F1
case_images: A 78-year-old Caucasian male presented with a chronic MH in the right eye measuring 655 mum in the narrowest diameter, as shown in Figure 1.
case_images: Color fundus photo after first ART surgery with graft initially within the macular hole with superior gas (a). Color fundus photo at postoperative week three showing graft now dislodged from the macular hole (b). OCT showing dislodged graft (c).
case_images: cop-2023-0014-0001-534142_F02.jpg
case_images: PMC10601871_01_cop-2023-0014-0001-534142_F02.jpg
case_images: F2
case_images: As shown in Figure 2a, initial follow-up found a well-centered graft with the closure of the MH, with subjective improvement in vision. On exam, the MH was noted to be reopened, and the ART graft completely dislodged, as shown in Figure 2b and c.
case_images: Color fundus photo at postoperative month four showing the graft within macular hole (green arrow) and adjacent two areas of CNVM (red arrows) (a). OCT at postoperative month four showing graft integration to the host tissue with slight graft "slippage" nasally (b). OCT angiography of the avascular layers at postoperative month three showing two areas of choroidal neovascular membranes near the macular hole (c). Color fundus photo at postoperative month 18 (d). OCT showing graft integration and "CME-like" inner retinal edema (e). CME, cystoid macular edema.
case_images: cop-2023-0014-0001-534142_F03.jpg
case_images: PMC10601871_01_cop-2023-0014-0001-534142_F03.jpg
case_images: F3
case_images: Some slippage of the graft at the nasal edge was noted on OCT imaging at postoperative month two but has remained non-progressive and outside the central fovea for approximately 1 year, as shown in Figure 3b. At postoperative month three, two separate choroidal neovascular membranes (CNVM) were seen at the sites of previous interoperative subretinal balanced salt solution (BSS) injection, presumably from Bruch's membrane compromise, as shown in Figure 3a. OCT imaging over the past 18 months has shown continued graft integration into the original MH, as shown in Figure 3d and e.