Case Report Case Series of Recurring Spontaneous Closure of Macular Hole Abdelrahman M. Elhusseiny , 1,2 William E. Smiddy , 1 Harry W. Flynn, 1 and Stephen G. Schwartz 1 1 Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL 33136, USA 2 Department of Ophthalmology, Kasr Al Ainy School of Medicine, Cairo University, Egypt Correspondence should be addressed to William E. Smiddy; wsmiddy@med.miami.edu Received 29 March 2019; Accepted 28 May 2019; Published 16 June 2019 Academic Editor: Maurizio Battaglia Parodi Copyright © 2019 Abdelrahman M. Elhusseiny et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Macular hole can undergo spontaneous reopening and reclosure. Tis is a retrospective review of three patients who had spontaneous reopening and reclosure of previously spontaneously closed macular hole documented by optical coherence tomography. We report the frst case of nivolumab-uveitis-associated macular hole formation. Te authors hypothesize that cystoid macular edema (CME) might alter the integrity of foveal tissues or conversely the orientation of the macular hole edges and play a role in formation and resolution of a macular hole. 1. Introduction Macular holes (MH) are a common cause of decreased central vision. Most MHs are idiopathic, but secondary causes include trauma and uveitis. Surgery is usually recommended, but spontaneous closure of full thickness macular hole (FTMH) has been reported in 0-6% with one series as high as 11.5% [1]. In as much as the original pathogenesis is incompletely understood, the mechanisms of spontaneous closure and reopening are even less well understood. Certain subsets, as uveitis-induced MH, are more likely to close spontaneously and perhaps physical efects from cystoid macular edema play a role [2]. Conversely, macular edema per se, rather than infammation, has been implicated as a causative element [3]. We present three patients who each had spontaneous MH closure, followed by reopening and reclosure; the MH closed spontaneously twice. One of these involved uveitis- associated macular edema caused by nivolumab therapy and represents the frst reported case associated with MH formation. 2. Case Description Case 1. An 80-year-old male presented with bilateral poste- rior uveitis and CME with onset 5 months afer initiating nivolumab (Opdivo) for treatment of metastatic cancer due to an unknown primary tumor. Best corrected visual acuity (BCVA) was 20/70 OD and 20/40 OS. Oral prednisone, topical difuprednate (Durezol), and nepafenac (Nevanac) were started. CME had resolved with improved BCVA (20/30 OU) afer 6 months of therapy. 9 months later, foveal thinning developed which progressed to a FTMH one month later (Figure 1(a)), reducing BCVA to 20/60 OS. Scheduled macular hole surgery (MHS) was cancelled when the vision improved to 20/40. OCT showed a closed MH, with residual subretinal fuid (SRF) (Figure 1(b)). Te condition remained stable until three months later when the patient presented with decreased VA (20/150). OCT showed reopening of the MH (Figure 1(c)). Te patient scheduled MHS but wanted to wait for 3 months, hoping for spontaneous resolution. 3 months later, MH spontaneously closed (Figure 1(d)) with improved VA to 20/80 OS. Te condition has remained stable with 20/70 BCVA. Hindawi Case Reports in Ophthalmological Medicine Volume 2019, Article ID 2398342, 4 pages https://doi.org/10.1155/2019/2398342