Management of traumatic macular holes: case report

Brasil, Oswaldo Ferreira Moura

doi:10.1590/s0004-27492008000400022

Cited by 13 publications

(15 citation statements)

References 17 publications

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“…It has been suggested that vitreous detachment and subsequent traction on the macular region may be causative; however, in many cases the vitreous is still firmly adherent to the retina and an alternative mechanism would therefore seem likely, such as direct rupture of the fovea due to transmitted force of impact. Other suggested pathogenic mechanisms, based on OCT examination of a developing macular hole, include the degeneration of cystoid macular oedema, subfoveal haemorrhage, contusion necrosis, and choroidal rupture as well as subclinical changes to the fovea [2,6,7] . The ILM of the retina has been hypothesised to produce traction on the edges of the macular hole and therefore to help keep it open.…”

Section: Discussionmentioning

confidence: 99%

Vitrectomy, Inner Limiting Membrane Peel, and Gas Tamponade in the Management of Traumatic Paediatric Macular Holes: A Case Series of 13 Patients

Brennan

Reekie²,

Khawaja³

et al. 2017

Ophthalmologica

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Purpose: To review the outcomes of pars plana vitrectomy, internal limiting membrane (ILM) peel, and gas tamponade in the management of traumatic paediatric macular holes. Methods: Retrospective case series of children undergoing vitrectomy, ILM peel, and gas tamponade for traumatic macular hole between March 2007 and July 2014. Main outcome measures were postoperative visual acuity at 3 and 12 months, anatomic closure rate, and surgical complications. Results: Anatomic macular hole closure was achieved in 12 (92.3%) of 13 cases. Mean preoperative logMAR visual acuity was 0.91 (95% CI 0.65-1.17) with improvement postoperatively to 0.54 (95% CI 0.43-0.64) at 3 months (p = 0.002) and 0.50 (95% CI 0.39-0.60) at 12 months (p = 0.002). There were no perioperative complications. Conclusion: Pars plana vitrectomy and ILM peel is an effective management option for paediatric macular holes.

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Section: Discussionmentioning

confidence: 99%

Vitrectomy, Inner Limiting Membrane Peel, and Gas Tamponade in the Management of Traumatic Paediatric Macular Holes: A Case Series of 13 Patients

Brennan

Reekie²,

Khawaja³

et al. 2017

Ophthalmologica

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“…In 2007, Brasil and Brasil [1] reported a single case of a 9-year-old boy with a TMH who gained vision from 20/300 to 20/70 after surgery with ILM peeling and silicone oil tamponade, which remained stable one year after the silicone oil removal.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, a multicenter case series of 25 TMH cases was published, and the authors observed a 96% closure rate and a vision of 20/50 or better in 64% of the eyes [1]. …”

Section: Discussionmentioning

confidence: 99%

“…As opposed to idiopathic macular holes, TMH are not associated with gradual onset and the mechanism of their formation remains controversial. Some authors theorized that the force of the impact transmitted to the macula could result in rupture of the fovea [1]. Another hypothesis is that sudden vitreous separation could be the cause of TMH, although most cases actually have an attached posterior vitreous [1, 2, 3].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors theorized that the force of the impact transmitted to the macula could result in rupture of the fovea [1]. Another hypothesis is that sudden vitreous separation could be the cause of TMH, although most cases actually have an attached posterior vitreous [1, 2, 3]. Other factors that may be involved are: outward expansion of the equator, flattening and subsequent posterior displacement of the posterior pole, trampoline-like movement, tangential tractional forces on retinal surface, contusion necrosis, cystoid degeneration, subfoveal hemorrhage, choroidal rupture, and anterioposterior vitreous traction.…”

Section: Introductionmentioning

confidence: 99%

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Management of Pediatric Traumatic Macular Holes - Case Report

Azevedo¹,

Ferreira²,

Meireles³

2013

Case Rep Ophthalmol

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Purpose: To report and describe the clinical course of four pediatric traumatic macular hole (TMH) cases and respective management. Case Report: Four pediatric patients with macular hole following blunt ocular trauma underwent early pars plana vitrectomy, with consecutive hole closure. Initial visual acuity was <20/400 or worse in all patients. After surgery, all patients had visual acuity improvement, with final visual acuity being >20/50 in 2 of the patients by the end of the follow-up. Macular hole closure was achieved in all patients with a single procedure, and anatomical success was confirmed by optical coherence tomography until the end of the follow-up. Conclusions: Although spontaneous closure of TMH is not uncommon, especially in pediatric patients, early pars plana vitrectomy seems to be a safe and effective choice in pediatric TMH management. The risk/benefit ratio of surgery seems to be better than observation.

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Spontanverschluss traumatischer Makulaforamina

et al. 2010

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The optimal treatment approach for traumatic macular holes (TMH) is still controversial. We report two cases of spontaneous closure of TMH. In the first patient, closure resulted in an increase in visual acuity from 0.2 to 0.8. In the second case, no increase in visual acuity was detectable despite spontaneous closure of the TMH within a few days after the trauma. This may be explained by an irreversible damage of the photoreceptors and retinal pigment epithelium. In patients with TMH, a waiting approach should be considered because of the possibility of spontaneous closure of TMHs.

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Management of traumatic macular holes: case report

Cited by 13 publications

References 17 publications

Vitrectomy, Inner Limiting Membrane Peel, and Gas Tamponade in the Management of Traumatic Paediatric Macular Holes: A Case Series of 13 Patients

Vitrectomy, Inner Limiting Membrane Peel, and Gas Tamponade in the Management of Traumatic Paediatric Macular Holes: A Case Series of 13 Patients

Management of Pediatric Traumatic Macular Holes - Case Report

Spontanverschluss traumatischer Makulaforamina

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