DR.PAURNIMA ULHAS BODHANKAR

DR. AJIT KAMALAKAR JOSHI

Abstract

A 55‑year‑old female presented with diminution of vision, night blindness, and gyrate atrophy with “double macular hole” in the left eye. Spectral‑domain optical coherence tomography of the left eye showed coexisting full thickness and lamellar macular hole with both eyes intra-retinal schisis and thin epiretinal membrane. After electroretinography and biochemical confirmation of gyrate atrophy, along with arginine‑restricted diet, left eye vitrectomy,ILM peeling with inverse flap and C3F8 gas tamponade was advised. Postoperatively complete closure of double hole with the resolution of schisis was achieved. However, at subsequent follow‑up and last follow up visit at 24 months, significant recurrence of intra-retinal schisis was noted due to the continued toxic effect of hyperornithinemia on inner retinal layers and retinal pigment epithelium, highlighting the need for effective future treatment options