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Evolution of macular hole in enhanced S-cone syndrome

Magliyah, Moustafa S. ; AlSulaiman, Sulaiman M. ; Schatz, Patrik LU orcid and Nowilaty, Sawsan R. (2021) In Documenta Ophthalmologica 142(2). p.239-245
Abstract

Purpose: To describe the stages of development and natural course of a full-thickness macular hole (FTMH) in a patient with enhanced S-cone syndrome (ESCS). Methods: This study reported the serial ophthalmologic examinations and macular spectral-domain optical coherence tomography (SD-OCT) imaging over a period of 6 years in a 29-year-old man with ESCS confirmed by electroretinography (ERG) and NR2E3 molecular genetic analysis. Results: At presentation, patient had night blindness and visual acuity (VA) of 20/300 in the right eye (OD) and 20/100 in the left eye (OS). Examination showed bilateral retinal midperipheral pigmentary deposits and a macular schisis in OD. Electroretinography and NR2E3 genetic analysis confirmed ESCS. A year... (More)

Purpose: To describe the stages of development and natural course of a full-thickness macular hole (FTMH) in a patient with enhanced S-cone syndrome (ESCS). Methods: This study reported the serial ophthalmologic examinations and macular spectral-domain optical coherence tomography (SD-OCT) imaging over a period of 6 years in a 29-year-old man with ESCS confirmed by electroretinography (ERG) and NR2E3 molecular genetic analysis. Results: At presentation, patient had night blindness and visual acuity (VA) of 20/300 in the right eye (OD) and 20/100 in the left eye (OS). Examination showed bilateral retinal midperipheral pigmentary deposits and a macular schisis in OD. Electroretinography and NR2E3 genetic analysis confirmed ESCS. A year later, a lamellar MH (LMH) appeared at the fovea in OD. SD-OCT confirmed it as inner retinal layer LMH with outer retinal preservation and displayed, on the temporal side of the LMH, prominent splitting between the inner and outer retinal layers. At 2 years, a focal defect in the ellipsoid zone appeared on SD-OCT, followed by split in the outer retinal layer creating a progressively expanding outer LMH. The latter had rolled edges which then fused with the inner LMH margins creating a single full-thickness FTMH. Over the next 4 years, enlargement of the FTMH with increased adjacent retinal splitting continued. No visible vitreous abnormalities or vitreoretinal traction forces were identified at any stage during follow-up. VA OD remained unchanged. Conclusion: This case illustrates that the clinical evolution of FTMH in ESCS may be progressive and likely involves degeneration and intraretinal, rather than vitreoretinal, traction. This should be kept in mind when considering surgical intervention in these cases.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Enhanced S-cone, Macular hole, Macular schisis, NR2E3
in
Documenta Ophthalmologica
volume
142
issue
2
pages
239 - 245
publisher
Springer
external identifiers
  • scopus:85089671942
  • pmid:32815098
ISSN
0012-4486
DOI
10.1007/s10633-020-09787-8
language
English
LU publication?
yes
id
45b65105-f577-4ecb-966c-fb166c08dbfc
date added to LUP
2021-01-13 14:50:26
date last changed
2024-04-17 23:53:22
@article{45b65105-f577-4ecb-966c-fb166c08dbfc,
  abstract     = {{<p>Purpose: To describe the stages of development and natural course of a full-thickness macular hole (FTMH) in a patient with enhanced S-cone syndrome (ESCS). Methods: This study reported the serial ophthalmologic examinations and macular spectral-domain optical coherence tomography (SD-OCT) imaging over a period of 6 years in a 29-year-old man with ESCS confirmed by electroretinography (ERG) and NR2E3 molecular genetic analysis. Results: At presentation, patient had night blindness and visual acuity (VA) of 20/300 in the right eye (OD) and 20/100 in the left eye (OS). Examination showed bilateral retinal midperipheral pigmentary deposits and a macular schisis in OD. Electroretinography and NR2E3 genetic analysis confirmed ESCS. A year later, a lamellar MH (LMH) appeared at the fovea in OD. SD-OCT confirmed it as inner retinal layer LMH with outer retinal preservation and displayed, on the temporal side of the LMH, prominent splitting between the inner and outer retinal layers. At 2 years, a focal defect in the ellipsoid zone appeared on SD-OCT, followed by split in the outer retinal layer creating a progressively expanding outer LMH. The latter had rolled edges which then fused with the inner LMH margins creating a single full-thickness FTMH. Over the next 4 years, enlargement of the FTMH with increased adjacent retinal splitting continued. No visible vitreous abnormalities or vitreoretinal traction forces were identified at any stage during follow-up. VA OD remained unchanged. Conclusion: This case illustrates that the clinical evolution of FTMH in ESCS may be progressive and likely involves degeneration and intraretinal, rather than vitreoretinal, traction. This should be kept in mind when considering surgical intervention in these cases.</p>}},
  author       = {{Magliyah, Moustafa S. and AlSulaiman, Sulaiman M. and Schatz, Patrik and Nowilaty, Sawsan R.}},
  issn         = {{0012-4486}},
  keywords     = {{Enhanced S-cone; Macular hole; Macular schisis; NR2E3}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{239--245}},
  publisher    = {{Springer}},
  series       = {{Documenta Ophthalmologica}},
  title        = {{Evolution of macular hole in enhanced S-cone syndrome}},
  url          = {{http://dx.doi.org/10.1007/s10633-020-09787-8}},
  doi          = {{10.1007/s10633-020-09787-8}},
  volume       = {{142}},
  year         = {{2021}},
}