Progressive Intramembranous Cystic Changes in Macular Hole-Associated Epiretinal Proliferation Over 3 Years

Purpose: To describe the progressive morphologic changes of macular hole (MH)-associated epiretinal proliferation over long-term follow-up and to explore potential pathologic mechanisms. Methods: A single case was retrospectively reviewed. Results: A patient with a history of open-angle glaucoma and proliferative diabetic retinopathy maintained stable visual acuity (VA) of 6/9 OD and 6/18 OS over 2 years. On examination, MH-associated epiretinal proliferation was noted in the left eye, demonstrating increased thickness and cystic changes compared with the previous visit, for which topical nepafenac eye drops were advised. A follow-up visit 1 year later showed a marked increase in the volume of epiretinal proliferation with associated intraretinal fluid, despite no change in VA. Conclusions: This report documents progressive structural changes in this infrequently encountered entity and explores the possible pathologic mechanisms through a review of relevant literature. Cystic changes with epiretinal proliferation may represent a benign process attributable to chronicity and often may not require intervention.