Claire W Ruan, Matthew George Schneiders, Muhammad Raja
We report 18 years of follow-up in a middle-aged Caucasian woman with retinitis pigmentosa (RP) and a non-tractional full-thickness macular hole (FTMH). The case was initially reported after 3 years of observation; this update provides a further 15 years of follow-up and, to our knowledge, represents the longest documented natural history of spontaneous FTMH closure in RP.At presentation, spectral-domain optical coherence tomography (SD-OCT) demonstrated a right-eye FTMH without vitreomacular traction. The patient elected conservative management with serial monitoring. The FTMH subsequently closed spontaneously, leaving a stable lamellar configuration that has remained anatomically unchanged without recurrence for almost two decades. Visual acuity gradually declined, likely due to progressive retinal degeneration and cataract progression, while OCT confirmed long-term foveal stability.This case demonstrates that spontaneous closure of a non-tractional FTMH in RP, although rare, can remain stable in the long term, supporting careful observation in selected patients.