Asymptomatic Unilateral Full-Thickness Macular Hole in a Patient with Bietti Crystalline Dystrophy During 13-Year Follow-up with Optical Coherence Tomography

A 39-year-old woman with progressive bilateral visual decline was diagnosed as having Bietti crystalline dystrophy in 2008. The disease course was monitored with optical coherence tomography until 2021. During the last routine eye examination in 2021, a full-thickness, slightly eccentric, visually asymptomatic macular hole with an intact foveola was noted in the left eye. No surgical treatment was recommended. The pathogenesis of full-thickness macular hole remained unclear as there were only subtle signs of prior very mild macular edema and vitreomacular interface abnormality. A degenerative process was also possible. Keywords: Bietti crystalline dystrophy, macula, macular hole, optical coherence tomography