Spontaneous Double Closure of a Secondary Full-Thickness Macular Hole: A Case Report

Full-thickness macular holes (FTMHs) are defects of the central retina that cause clinically significant symptoms, including reduced visual acuity. Spontaneous closure may occur in a minority of cases, and pars plana vitrectomy (PPV) remains the gold-standard treatment. This report describes a patient who had previously undergone PPV and, during follow-up, was diagnosed with an FTMH at the Hospital das Clínicas, Faculty of Medicine, University of São Paulo (HCFMUSP), for whom surgical intervention was initially indicated. Prior to the scheduled surgery, the macular hole (MH) closed spontaneously. Several months later, the lesion recurred, and vitrectomy was again recommended. However, during preoperative follow-up, a second spontaneous closure was observed. To date, the patient has remained under clinical observation, and no surgical intervention has been required for this condition. This case highlights the dynamic behavior of secondary FTMHs and emphasizes the importance of longitudinal optical coherence tomography (OCT) follow-up in selected patients.