Original articleSpontaneous closure of traumatic macular hole
Section snippets
Patients and methods
We reviewed clinical records of a consecutive series of 18 eyes of 18 patients with traumatic macular hole who were referred to us between 1986 and 2000. They were first examined on the following day or within 2 weeks after trauma and observed without surgery for a mean follow-up time of 8.4 months (range, 4–12 months). Routine examination included history taking for causes of injury and onset of visual symptoms, recording of best-corrected visual acuity, refraction, contact lens biomicroscopy,
Results
In a consecutive series of 18 eyes of 18 patients with traumatic macular hole, eight (44%) eyes showed a spontaneous hole closure. Table 1 summarizes the clinical characteristics of the eight eyes of spontaneous macular hole closure. All eight patients were males with a mean age of 14.6 years (range, 11 to 21 years). The major cause of injury was sports-related accidents including contusion by soccer ball and baseball. As regards the onset of visual symptoms, six patients had immediate visual
Case 1
A 13-year-old boy had his right eye accidentally hit by a vinyl slipper and immediate visual loss. He was referred to us on the following day. Best-corrected visual acuity of the affected eye was 0.02. Contact lens biomicroscopy revealed commotio retinae in the posterior pole and a small macular hole not complicated by cuff of subretinal fluid, epiretinal membrane, or posterior vitreous detachment (Figure 1A). Optical coherence tomography showed a full-thickness macular hole with a thickened
Discussion
In our series of 18 eyes of traumatic macular hole, eight (44%) showed spontaneous hole closure at a mean follow-up of 8.4 months. Mizusawa and associates5 reported that one (10%) of ten eyes achieved spontaneous hole closure at a follow-up of 8 months or longer, and Tomii and associates6 reported that four (67%) of six eyes had spontaneous hole closure during a follow-up of 3 months or longer. Thus, spontaneous closure of traumatic macular hole is obviously not uncommon, but its general
References (13)
- et al.
Spontaneous disappearance of traumatic macular holes in young patients
Am J Ophthalmol
(1997) - et al.
Postsurgical evaluation of idiopathic vitreomacular traction syndrome by optical coherence tomography
Am J Ophthalmol
(2001) Über isolierte Zerreisungen der Aderhaut in Folge von Traumen auf dem Augapfel
Arch Augenheilkd
(1869)Macular holesA review
Surv Ophthalmol
(1970)- et al.
Contusion effects on the retina
- et al.
Clinical characteristics of traumatic macular hole
Jpn J Ophthalmol
(1996)