Academic Journal
Under pressure: Foveal mountain peak sign and macular hole after ruptured RAM.
| Title: | Under pressure: Foveal mountain peak sign and macular hole after ruptured RAM. |
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| Authors: | Domínguez-Varela IA; Retina Department, Asociación Para Evitar la Ceguera en México I.A.P. 'Dr. Luis Sánchez Bulnes', Mexico City, Mexico. Electronic address: irv_dominguez@hotmail.com., López-Montoy MA; Retina Department, Asociación Para Evitar la Ceguera en México I.A.P. 'Dr. Luis Sánchez Bulnes', Mexico City, Mexico., Enriquez-Vera GE; Retina Department, Asociación Para Evitar la Ceguera en México I.A.P. 'Dr. Luis Sánchez Bulnes', Mexico City, Mexico. |
| Source: | Archivos de la Sociedad Espanola de Oftalmologia [Arch Soc Esp Oftalmol (Engl Ed)] 2026 Sep; Vol. 101 (9), pp. 502553. Date of Electronic Publication: 2026 Apr 15. |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier España Country of Publication: Spain NLM ID: 101715860 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2173-5794 (Electronic) Linking ISSN: 21735794 NLM ISO Abbreviation: Arch Soc Esp Oftalmol (Engl Ed) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Madrid : Elsevier España |
| MeSH Terms: | Retinal Perforations*/etiology , Retinal Perforations*/diagnostic imaging , Retinal Arterial Macroaneurysm*/complications , Retinal Arterial Macroaneurysm*/diagnostic imaging , Retinal Hemorrhage*/etiology , Retinal Hemorrhage*/diagnostic imaging , Fovea Centralis*, Sulfur Hexafluoride/administration & dosage ; Humans ; Male |
| Abstract: | To describe a case of a macular hole (MH) secondary to a submacular hemorrhage caused by a ruptured retinal arterial macroaneursym (RAM). An individual case and its observations were examined. Initial examination revealed no visible MH due to the hemorrhagic clot. Two weeks later, a full-thickness MH measuring 340 μm was detected. Pneumatic displacement with sulfur hexafluoride (SF6) was performed to reduce hemorrhagic toxicity and potentially promote spontaneous closure. However, after three months, the MH persisted with no evidence of closure, and visual acuity remained reduced (20/150). The Foveal mountain peak sign (FMP) was identified as a useful predictive indicator of MH formation. MHs secondary to ruptured RAMs and submacular hemorrhages may be initially obscured by hemorrhagic clots, complicating early diagnosis. The FMP sign can aid in predicting MH development. Given the risk of persistent MH and visual impairment, especially when the RAM rupture is close to the fovea (<1500 μm), early surgical intervention should be considered. (Copyright © 2026 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare no conflicts of interest or financial disclosures. |
| Contributed Indexing: | Keywords: Agujero macular; Foveal mountain peak sign; Macroaneurisma arterial retiniano; Macular hole; Retina; Retinal arterial macroaneurysm; Signo de pico de montaña foveal |
| Substance Nomenclature: | WS7LR3I1D6 (Sulfur Hexafluoride) |
| Entry Date(s): | Date Created: 20260417 Date Completed: 20260831 Latest Revision: 20260910 |
| Update Code: | 20260911 |
| DOI: | 10.1016/j.oftale.2026.502553 |
| PMID: | 41997528 |
| Database: | MEDLINE |
| ISSN: | 2173-5794 |
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| DOI: | 10.1016/j.oftale.2026.502553 |