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

## TL;DR

A patient experienced two spontaneous closures of a macular hole without needing surgery, showing that such cases can sometimes heal on their own.

## Contribution

This case report documents two rare spontaneous closures of a secondary full-thickness macular hole.

## Key findings

- The patient's macular hole spontaneously closed before the first scheduled surgery.
- A second spontaneous closure occurred before a second surgery, eliminating the need for further intervention.
- Long-term OCT monitoring proved effective in tracking the condition's progression and recovery.

## Abstract

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.