Full thickness macular hole in neovascular age related macular degeneration – a case series of 4 patients successfully treated with vitrectomy

Abstract Background Full thickness macular holes (FTMH) exacerbated by neovascular age related macular degeneration (AMD) are a relatively rare ophthalmic entity. Due to the latter significantly lowering the threshold potential for visual recuperation, ophthalmologists are reluctant to treat these patients surgically. However time is of the essence and considering other factors, this decision should be made by an experienced vitreoretinal surgeon, who can elect the patient for vitrectomy if other ophthalmic factors are in favour and allow it. Case reports We present a case series of 4 patients diagnosed with a dual pathology of AMD and FTMH. Macular hole closure was achieved on OCT imaging and VA improed to the level which was determined by the macular state due to wet AMD. Conclusions Full-thickness macular holes should be promptly treated surgically to achieve disease control, regardless of their etiology. A conservative approach may lead to further and irreversible deterioration of central visual acuity, despite reports on spontaneous closure and variable functional improvement. During vitrectomy, no additional choroidal membrane (CNV) excision was proven to improve the outcomes, which can be even worsened, therefore this modification should be avoided.