Macular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure. A 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later. Dynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.

中文翻译：

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伴有息肉样脉络膜血管病引起的黄斑下出血的继发性黄斑裂孔的发展和自发闭合：病例报告

黄斑裂孔（MH）是黄斑中央凹的视网膜断裂，包括部分或完全裂开的神经视网膜层，通过降低视敏度（VA）和视觉变形影响视力质量。我们描述了一例因多发性脉络膜脉管病变（PCV）而引起的黄斑下出血（SMH）继发性MH，表现为自发性闭合。一名67岁的男子因SMH导致右眼视力下降。VA为20/50，每月玻璃体内注射阿柏西普3次。SMH逐渐降低，并且10个月后，发现外部限制膜被穿孔，形成了MH。旧的血块消失了，MH保留了10个月。23个月后，出现了涉及黄斑的浆液性视网膜脱离（SRD），MH消失了。SRD逐渐消失，黄斑形态恢复。VA逐渐改善，并在38个月后变为20/20。可以清楚地观察到在二次发育和自发闭合的MH的异常情况下超微结构的动态变化。尽管机理尚不清楚，但认为小直径和渗出性PCV促成了闭合。