Brasil Oswaldo Ferreira Moura, Brasil Oswaldo Moura
Instituto Brasileiro de Oftalmologia, Rio de Janeiro, Brasil.
Arq Bras Oftalmol. 2008 Jul-Aug;71(4):581-4. doi: 10.1590/s0004-27492008000400022.
Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.
外伤性黄斑裂孔是一种发病机制尚未完全明确且最佳治疗指南存在争议的疾病。我们报告2例采用不同治疗方法的外伤性黄斑裂孔病例。第一例,一名9岁男孩因眼部被石块钝挫伤继发外伤性黄斑裂孔,初始视力为20/300。他接受了手术修复,随访1年后最终视力为20/70,裂孔闭合。第二例,一名20岁女性前额左侧遭受贯通性枪伤。该损伤导致左眼视神经乳头撕脱,光感丧失。右眼有外伤性黄斑裂孔及提示猎枪伤性脉络膜视网膜炎的体征,视力为20/60。该病例最初进行观察,视力改善至20/30,裂孔直径缩小。8个月后视力和裂孔直径保持稳定。