Macular Hole Formation Secondary to Bacterial Septic Embolism Demonstrated by Serial Spectral-domain Optical Coherence Tomography Imaging

Abstract

Purpose: To describe a case of macular hole (MH) formation secondary to bacterial septic embolism and demonstrate the changing thereof using serial spectral-domain optical coherence tomography (SD-OCT) images.

Methods: A single case report.

Results: A 69-year-old woman who had been diagnosed with Klebsiella pneumonia septicemia was referred for decreased vision in her left eye. Impending MH was detected by SD-OCT and retinitis with multiple retinal hemorrhages by funduscopy. One week after the initial visit, a full-thickness MH had formed, and 13 weeks after the initial visit, we were able to close the MH following vitrectomy and gas tamponade. The MH was formed by retinal thinning due to outer retinal disruption without vitreomacular traction.

Conclusion: Metastatic retinal septic embolism and consequent outer retinal disruption can cause MH. Ophthalmologists must be aware of the possibility of MH in cases of retinal metastatic bacterial septic embolism, especially if the lesion infiltrates the fovea.

• bacterial septic embolism
• macular hole
• optical coherence tomography
• spectral domain
• visual acuity