ABSTRACT
A 7-year-old boy presented with history of blunt trauma 1 month back. Best corrected visual acuity (BCVA) was 20/200 with optical coherence tomography (OCT) showing a large macular hole. Spontaneous closure of the macular hole seemed unlikely following a month of observation. Pars plana vitrectomy along with autologous retinal graft was performed. At subsequent follow up, hole appeared closed with nasal shrinkage of graft and BCVA improved to 20/100. OCT showed mechanical integration of the graft with adjoining retina. Autologous retinal graft is a feasible option in cases where conventional internal limiting membrane peeling shows lower anatomical success.
ABSTRACT
·AIM: To observe the application of optical coherence tomography ( OCT ) in the diseases of traumatic macular hole.·METHODS: Twenty - five eyes of 23 patients with traumatic macular hole from January 2015 to January 2017 were enrolled in this study, including 9 eyes treated without surgeries, 16 eyes with surgeries. The image features were analyzed using OCT from ZEISS.·RESULTS: The OCT characteristics in patients with traumatic macular hole were partial or full - thickness disappearance of the neuro-epithelium. Posterior vitreous detachment was not seen in the traumatic macular hole. OCT examination revealed that 4 eyes had partial detachment of macular hole and 21 eyes had full thickness detachment. Of the twenty-one eyes, 4 eyes had simple macular hole, 10 eyes had macular full-layer division with peripheral nerve epithelium edema, 7 eyes had the macular full - layer hole with the neuro - epithelium localized detachment. In the 25 eyes, 9 eyes did not undergo the surgery, of which 7 eyes were self-healing;16 eyes were surgically treated. Postoperative OCT showed the macular structure were normal in 12 eyes with the visual acuity improved 3 lines; retinal nerve epithelium were thinning in 4 eyes, visual acuities were not significant improved after surgery.·CONCLUSION: OCT examination is necessary for the diagnosis and treatment of traumatic macular hole.
ABSTRACT
The association of macular detachment with posttraumatic macular hole is a known but rare occurrence. Spontaneously occurring resolution of the detachment and closure of the macular hole has been reported only once in the literature. We describe a similar rare event in a young male, the documentation of which was done serially by microperimetry (MP) and optical coherence tomography (OCT). A 17-year-old male presented with a decrease in vision following a closed globe injury to the left eye. A coexisting macular hole and macular detachment were detected in the affected eye. Serial follow-up with OCT and MP documented complete resolution of the macular hole and the macular detachment within 1 week of presentation. The case highlights that spontaneous resolution of traumatic macular hole and related macular detachment may occur and a waiting period is advisable before undertaking any corrective surgical procedure. The pathophysiologic mechanisms of causation and the resolution of posttraumatic macular hole-related retinal detachment are discussed.
Subject(s)
Adolescent , Eye Injuries/complications , Eye Injuries/diagnosis , Eye Injuries/physiopathology , Follow-Up Studies , Humans , Male , Remission, Spontaneous , Retinal Detachment/complications , Retinal Detachment/diagnosis , Retinal Perforations/diagnosis , Retinal Perforations/etiology , Retinal Perforations/physiopathology , Tomography, Optical Coherence/methods , Visual Acuity , Visual Field Tests/methods , Visual Fields , Wounds, Nonpenetrating/complications , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/physiopathologyABSTRACT
PURPOSE: To report a case of eccentric macular hole formation after surgery for a traumatic macular hole. CASE SUMMARY: A 27-year-old man was admitted to our hospital because of baseball trauma to his left eye. A vitreous hemorrhage and Berlin's edema were found in the macula. One month later, a full thickness macular hole was detected. Vitrectomy and internal limiting membrane (ILM) peeling and gas injection were performed. Two months postoperatively, the primary macular hole was closed, but an eccentric macular hole temporal to the fovea was observed.
Subject(s)
Adult , Humans , Baseball , Edema , Eye , Membranes , Retinal Perforations , Vitrectomy , Vitreous HemorrhageABSTRACT
We injected tissue plasminogen activator(TPA) and expansile gas into the vitreous of 17-year-old patient who presented with traumatic macular hole and subretinal hemorrhage. Most of the subretinal hemorrhage drained into the vitreous cavity through the macular hole. Two weeks after intravitreal injection, closure of macular hole accompanied by complete posterior vitreous detachment was observed. This case suggests that the tangential vitreous traction may play an important role in the development of traumatic macular hole as in the development of idiopathic macular hole. It is speculated that the induction of posterior vitreous detachment without vitrectomy can result in removal of this traction and closure of traumatic macular hole.