Supplementary Material for: Sealed Unilateral Full-Thickness Macular Hole with Amniotic Membrane Graft in a Patient with Alport Syndrome: A Case Report

We present a case of unilateral full-thickness macular hole (MH) successfully repaired with an amniotic membrane graft in a patient with Alport syndrome. A 58-year-old Asian female with past medical history of Alport syndrome diagnosed at early stage, presented with a 5-week history of vision loss in her right eye. Examination of her eyes showed normal retinal vessels and a MH measuring 1300um in basal diameter, 806um in minimum linear diameter, and 490um in height in the right eye and macular thinning with laser scars inferiorly in the left eye. The patient underwent 23 g pars plana vitrectomy with intraocular lens explantation. After multiple unsuccessful attempts in inducing a posterior vitreous detachment around the optic nerve and in the posterior pole, a 1 mm amniotic membrane (AM) graft placed on the MH and the edges tucked under the edges of the hole using a bimanual technique. Five months after surgery, the MH remained sealed with improved final vision. MHs are rare manifestations of Alport syndrome and surgical treatment of Alport syndrome associated MHs is challenging. However, further studies to explore new techniques using AM is needed.

本研究报告1例伴发于奥尔波特综合征（Alport syndrome）的单侧全层黄斑裂孔（macular hole, MH），经羊膜（amniotic membrane, AM）移植术成功修复。患者为58岁亚裔女性，早年确诊奥尔波特综合征，因右眼视力下降5周前来就诊。眼部检查结果显示：右眼视网膜血管未见异常，黄斑裂孔基底直径1300μm、最小线性直径806μm、高度490μm；左眼黄斑组织变薄，下方区域可见激光治疗瘢痕。患者接受23G扁平部玻璃体切除术联合人工晶状体取出术。术中在视神经及后极部周围尝试诱导后玻璃体脱离均告失败，遂采用双手操作技术将1mm大小的羊膜移植片覆盖于黄斑裂孔表面，并将移植片边缘缝合固定于裂孔边缘下方。术后5个月随访显示，黄斑裂孔保持闭合，患者最终视力较术前有所改善。黄斑裂孔是奥尔波特综合征的罕见眼部并发症，其外科治疗颇具挑战，未来仍需开展更多研究以探索基于羊膜移植的新型手术技术。