Traumatic macular hole: Clinical aspects and controversies

2020 ◽  
Vol 3 ◽  
pp. 3
Author(s):  
David Pelayes ◽  
Francesc March de Ribot ◽  
Ferenc Kuhn ◽  
Sundaram Natarajan ◽  
Wolfang Schrader

The traumatic macular hole is a rare pathology posterior to eye injuries, resulting in loss of visual acuity. It generally affects young men. The pathogenesis of macular hole formation after blunt trauma is today controversial. They frequently appear immediately after the injury, nevertheless in some cases can occur weeks later. The vision usually ranges between 20/80 and 20/400. The exploration typically shows a full-thickness defect of the neurosensory retina at the fovea, elliptical, and with irregular edges. The management can include observation under certain conditions because there is a chance of spontaneous closure. Surgery with vitrectomy obtains the closure of the hole in between 92% and 96% of cases.

2021 ◽  
pp. 481-484
Author(s):  
Masahisa Watanabe ◽  
Harumasa Yokota ◽  
Hiroshi Aso ◽  
Hirotsugu Hanazaki ◽  
Junya Hanaguri ◽  
...  

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.


Retina ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 473-476 ◽  
Author(s):  
HIDEKI KOIZUMI ◽  
JASON S. SLAKTER ◽  
RICHARD F. SPAIDE

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