Spontaneous closure of traumatic macular hole

Yamashita, Takehiro; Uemara, Akinori; Uchino, Eisuke; Doi, Norihito; Ohba, Norio

doi:10.1016/s0002-9394(01)01303-4

Cited by 140 publications

(120 citation statements)

References 5 publications

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“…However, Yamashita et al 21 reported spontaneous closure of TMH in 44.4% (8 eyes) of 18 patients. They revealed in three cases that were examined with OCT two distinct abnormalities; acute foveal dehiscence without the involvement of the posterior vitreous cortex, and vitreous detachment with residual vitreous adhesion to the edge of updrawn fovea that developed the release of the foveal adhesion at the time of hole closure.…”

Section: Discussionmentioning

confidence: 98%

Optical coherence tomography characteristics of full-thickness traumatic macular holes

Arévalo¹,

Sánchez²,

Costa

et al. 2007

Eye

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Purpose The objective of this paper is to describe the optical coherence tomography (OCT) characteristics of patients with fullthickness traumatic macular hole (TMH) and to correlate them with biomicroscopy findings. Methods Twelve eyes of ten consecutive patients with full-thickness TMH participated in this observational retrospective multicentre study. Patients underwent biomicroscopic fundus examination, colour fundus photography, and OCT. Results Traumatic macular hole was documented with OCT in five women and five men. Mean (range) time between trauma and macular hole (MH) diagnosis was 8.1 (1-24) months. The shape of TMHs was round in 11 (91.7%) eyes. The posterior vitreous was completely detached in six (50%) eyes, and with an operculum in one (8.3%) eye. The common findings seen on OCT were: (1) fullthickness loss of retinal tissue through the hole with sharp edges, perpendicular to the retinal pigment epithelium in five (41.7%) eyes; (2) TMH with an operculum totally detached from the hole's edge in two (16.7%) eyes; (3) presence of epiretinal membrane around of the hole in three (25%) eyes; and (4) presence of abnormalities of the surrounding retina in all (100%) eyes. The OCT characteristics correlated well with biomicroscopic findings, and these characteristics may be predictive for final visual acuity (VA) in TMHs. Only one of the TMHs closed spontaneously in our series. Conclusion Optical coherence tomography complements biomicroscopy in the evaluation of full-thickness TMHs.

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Section: Discussionmentioning

confidence: 98%

Optical coherence tomography characteristics of full-thickness traumatic macular holes

Arévalo¹,

Sánchez²,

Costa

et al. 2007

Eye

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“…Two different mechanisms are believed to lead to the formation of TMH, depending on whether the posterior hyaloid is attached or detached. A TMH is thought to occur either as a primary concussive tear or as a secondary breakdown of traumatically induced cystoid changes (2) . In the case in question, the OCT showed a TMH with an intact posterior vitreous face already 10 days after the injury.…”

Section: Discussionmentioning

confidence: 99%

“…Common features between this patient and the patients with spontaneous closure of TMH described in the literature were the young age, the small size of the macular hole, and the failure of a posterior hyaloid detachment (1) . The relatively higher rate of spontaneous closure of TMH (10-66% in adults) (1,2) may be explained by an adherent posterior vitreous membrane (5) and the absence of permanent traction from an epiretinal membrane compared to idiopathic macular holes (6) . The time elapsed from the trauma to the spontaneous closure is variable.…”

Section: Discussionmentioning

confidence: 99%

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

Sartori¹,

Stefanini²,

Moraes³

2012

Arq. Bras. Oftalmol.

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Spontaneous closure of a traumatic macular hole (TMH) is an unusual outcome. Op tical coherence tomography (OCT) and clinical follow-up enabled monitoring of this resolution during a period of a few weeks. We describe a case of spontaneous closure of a TMH with complete visual recovery in a 15 year-old boy and show the follow-up of the macular hole obtained using the Spectral Domain OCT. Keywords

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“…Spontaneous resolution of small full-thickness macular holes following trauma in young patients is not uncommon and can be associated with good visual recovery. 25 Optical coherence tomography (OCT) is a powerful non-invasive, non-contact imaging technique capable of producing cross-sectional images of ocular tissue in vivo of high longitudinal resolution (10 mm). OCT has yielded important insights into the pathogenesis of macular hole development and the mechanism of surgical repair.…”

Section: Pathogenesis Of Macular Holesmentioning

confidence: 99%

Macular holes: vitreoretinal relationships and surgical approaches

Bainbridge

Herbert

Gregor

2008

Eye

100

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Idiopathic full-thickness macular holes develop as a result of anteroposterior and tangential traction exerted by the posterior vitreous cortex at the fovea. Vitreoretinal relationships during the development of macular holes can be demonstrated in detail by ocular coherence tomography, facilitating an improved understanding of their pathogenesis and guiding clinical management. Surgical strategies for the repair of macular holes are designed to relieve vitreofoveal traction and to promote flattening and reapposition of the macular hole edges by intraocular gas tamponade. A period of facedown positioning postoperatively is conventionally advised. However, the evidence to support this recommendation is weak and practice varies considerably. Surgical removal of the inner limiting membrane (ILM) is advocated to ensure thorough removal of any tangential tractional components including any residual cortical vitreous. Current evidence suggests that ILM peeling can improve anatomical outcomes but the effect on visual function is less predictable; unsuccessful attempts to peel the ILM can be associated with poor visual outcome. The use of vital dyes can facilitate visualisation of the ILM and help achieve complete, atraumatic peeling. Indocyanine green dye can enable high rates of macular hole closure but has been associated with poorer visual outcomes suggesting a dosedependent toxicity. Trypan blue dye offers an alternative that may have a more favourable risk profile. An improved understanding of vitreoretinal relationships may facilitate a tailored approach to surgery in individuals with macular holes. Vitrectomy to relieve anteroposterior traction is central in the management of all full-thickness holes. The use of long-acting gases, prolonged face-down positioning, and ILM peeling may be more valuable for larger holes, longstanding holes, and those that have failed to close following conventional surgery.

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Spontaneous closure of traumatic macular hole

Cited by 140 publications

References 5 publications

Optical coherence tomography characteristics of full-thickness traumatic macular holes

Optical coherence tomography characteristics of full-thickness traumatic macular holes

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

Macular holes: vitreoretinal relationships and surgical approaches

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