Supplementary Material for: The Hole Story: Spontaneous Closure After Reopening

Introduction
We report a case of spontaneous closure after early reopening of a previously successfully treated macular hole (MH).
Case Presentation
A 73-year-old patient presented with visual acuity of 20/100 and complained of defective vision. Examination and investigations confirmed a full-thickness MH. Surgical intervention led to complete closure of the hole on OCT within 5 days. However, the patient reported recurrence of symptoms 2 weeks later, and reopening of the hole was diagnosed. Re-surgery was advised, but surprisingly, the hole spontaneously closed by the seventh week and remained closed at the last follow-up (6 months post-surgery), with visual acuity improving to 20/50.
Conclusions
Reopening of a MH can occur months or years after successful treatment, and the underlying reasons remain unclear. While reoperation is often indicated, spontaneous healing, although rare, is possible. This case highlights the potential for spontaneous closure of a reopened macular hole, suggesting that a wait-and-watch approach may be worthwhile before deciding on further surgery.

引言
本研究报告1例既往经成功治疗的黄斑裂孔（macular hole, MH）早期复发后发生自行闭合的病例。

病例介绍
1例73岁患者因视力为20/100就诊，主诉视物缺损。眼科检查及辅助检查证实为全层黄斑裂孔。手术干预后5天内，光学相干断层扫描（optical coherence tomography, OCT）显示裂孔完全闭合。然而患者于术后2周主诉症状复发，经检查诊断为黄斑裂孔复发。医师建议行再次手术，但令人意外的是，至术后第7周时裂孔自行闭合，且在末次随访（术后6个月）时仍保持闭合状态，患者视力提升至20/50。

结论
黄斑裂孔经成功治疗后可在数月乃至数年后复发，其潜在机制仍未明确。尽管再次手术通常具有手术指征，但自行愈合虽属罕见，仍有可能发生。本病例证实了复发的黄斑裂孔存在自行闭合的可能性，提示在决定实施进一步手术前，采取观察等待的策略或具有临床价值。