Spontaneous closure of pediatric traumatic macular hole: case report and spectral-domain OCT follow-up

Sartori, Juliana; Stefanini, Francisco Rosa; Moraes, Nilva Simeren Bueno de

doi:10.1590/s0004-27492012000400015

Cited by 10 publications

(11 citation statements)

References 9 publications

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“…Vitrectomy is used as the backbone of all treatments with various additional adjuvant techniques suggested as beneficial by different authors. It has been noted that macular holes may spontaneously close in some patients, and therefore a period of watchful waiting has been advised by some [9] . However, at younger ages there is a risk of amblyopia developing due to reduced visual acuity caused by a macular hole [4] , meaning that conservative management even for a short amount of time is not a risk-free strategy.…”

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 the earlier published case reports and case series, absence of intraretinal cysts has not been reported as a factor for closure of macular hole. However, most instances where traumatic macular holes closed spontaneously were not accompanied by intraretinal cysts on OCT 11 12 13 14 15 16 17 18 19 20 21 22 23 , although there are also a few cases with spontaneous closure in the presence of intraretinal cysts 24 25 26 . The presence of intraretinal cysts may be an indicator of internal limiting membrane traction, which may activate Müller cells and cause accumulation of extracellular fluid in the retina.…”

Section: Discussionmentioning

confidence: 99%

Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography

Chen

Zheng

et al. 2015

Sci Rep

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It has been known that some traumatic macular holes can close spontaneously. However, knowledge about the types of macular hole that can close spontaneously is limited. In this retrospective study, we investigated patients with traumatic macular hole who were followed-up for at least 6 months without any surgical intervention. Clinical data and spectral domain optical coherence tomography (SD-OCT) images were compared between groups with and without macular hole closure. Overall, 27 eyes were included. Spontaneous closure of macular hole was observed in 10 (37.0%) eyes. The holes with spontaneous closure had smaller minimum diameter (244.9 ± 114.4 vs. 523.9 ± 320.0 μm, p = 0.007) and less intraretinal cysts (10% vs. 76.5%, p = 0.001) compared to the holes that did not close spontaneously. The area under the curve of receiver operative characteristic was 0.812 and 0.832 for minimum diameter of macular hole and presence of intraretinal cysts respectively. Multivariate logistic regression showed that the presence of intraretinal cysts was an independent predictive factor for closure of macular holes. The group with spontaneous macular hole closure had a high chance of visual improvement. Our study suggests that the absence of intraretinal cysts on SD-OCT can predict spontaneous closure of traumatic macular hole.

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“…On the other hand, there are some reports which deduced that the common feature of cases of spontaneous hole closure was the absence of development of posterior hyaloid detachment [2,9]. Other common features of spontaneously closed TMH cases are young age and smaller hole diameter [2,9,10]. In the case reported herein, there was no posterior hyaloid de-tachment on OCT neither before nor after trauma.…”

Section: Discussionmentioning

confidence: 67%

“…Some authors suggested that the development of epiretinal membranes leads to the contraction of the hole resulting in closure of the hole [6], others suggested RPE and glial cells adjacent to the macular hole proliferated and closed the hole [7], or total posterior hyaloid detachment facilitated hole closure by reducing the anteroposterior tractional forces [8]. On the other hand, there are some reports which deduced that the common feature of cases of spontaneous hole closure was the absence of development of posterior hyaloid detachment [2,9]. Other common features of spontaneously closed TMH cases are young age and smaller hole diameter [2,9,10].…”

Section: Discussionmentioning

confidence: 99%

Observation of the development and spontaneous closure of a traumatic macular hole by optical coherence tomography

Üçer¹

2019

Ann Clin Anal Med

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We report a case of a traumatic macular hole (TMH) formation which occurred several days after a blunt trauma in a child in order to demonstrate its spontaneous closure by daily optical coherence tomography (OCT) findings. A nine-year-old boy applied to the outpatient clinic with skin injury in the zygoma region which was caused by blunt trauma. Foveal contour was normal and subretinal and intraretinal fluid was detected on OCT. On the 2nd day, the subretinal fluid increased. On the 3rd day, there was a slight separation between the outer plexiform layer and the outer nuclear layer, suggesting a lamellar hole. A full-thickness macular hole with a base width of 360 microns was observed on the 7th day. On the 3rd week of follow-up, the OCT revealed closure of macular hole. A slight foveal depression and highly reflective accumulation and shadowing of retinal pigment epithelium were detected. A spontaneous closure may be observed in TMHs, especially in patients within the pediatric age group. Observation may be a better therapeutic option for TMHs before deciding on a macular surgery in childhood.

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Spontaneous closure of pediatric traumatic macular hole: case report and spectral-domain OCT follow-up

Cited by 10 publications

References 9 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

Prediction of spontaneous closure of traumatic macular hole with spectral domain optical coherence tomography

Observation of the development and spontaneous closure of a traumatic macular hole by optical coherence tomography

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