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Clinical analysis of 47 cases with traumatic macular hole resulted from ocular contusion

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Author:
No author available
Journal Title:
Chinese Journal of Ocular Fundus Diseases
Issue:
1
DOI:
10.3760/cma.j.issn.1005-1015.2015.01.012
Key Word:
视网膜穿孔/外科学;视网膜穿孔/药物疗法;玻璃体切除术;Retinal perforations/surgery;Retinal perforations/drug therapy;Vitrectomy

Abstract: Objective To analyze the clinical characteristic,treatment and prognosis of traumatic macular holes resulted from ocular contusion.Methods The clinical data of 47 cases with traumatic macular hole was retrospectively reviewed.The general condition of the patients was summarized,optical coherence tomography and multifocal electroretinogram (mfERG) were used to evaluate anatomic and functional outcomes.The patients were divided into observation group and surgery group by the treatment they received,and the prognosis was evaluated.Results Traumatic macular hole occurs mainly in male.In the observation group,the mean diameter of macular hole was(490.0±86.9) μm.During the 12 month follow up,the holes in 7 cases (33.3%) were closed spontaneously,Vision and diameters of 14 cases (57.1%) maintained stable for a long time,the vision of 1 case (3.3 %) declined mildly and the diameter of 1 case (3.3%) enlarged slightly.Visual acuity was improved significantly at last follow up (Z=-2.40,P< 0.05).The amplitudes of N1 wave of mfERG increased both in central fovea and macular area(t=13.30,5.06;P<0.05).These data suggests that the macular function was recovered well.In the surgery group,the mean diameter of macular hole was (643.3 ± 125.0) μm and statistically larger than that of the observation group (t=-4.76,P<0.05).At the last follow-up,visual acuity were not improved significantly (Z=-1.79,P>0.05).The amplitudes of N1 wave in 6 cases (23.1 %) improved merely and the difference was not statistically significant (t =1.98,P > 0.05).These data suggests that the macular function was recovered slightly only in a few patients.Conclusions A part of the patients with smaller diameters of macular holes may close spontaneously,and they may get better visual acuity.Vitrectomy may help to close the macular holes in some severe cases,but the improvement of functional outcomes is not significant.

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