Alsulaiman Sulaiman M, Alrushood Abdulaziz Adel, Almasaud Jluwi, Alkharashi Abdullah S, Alzahrani Yahya, Abboud Emad B, Nowilaty Sawsan R, Arevalo J Fernando, Al-Amry Mohammad, Alrashaed Saba, Ghazi Nicola G
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Vitreoretinal Division, Department of Ophthalmology, King Saud University, College of Medicine, Riyadh, Saudi Arabia.
Am J Ophthalmol. 2015 Jul;160(1):107-13.e1. doi: 10.1016/j.ajo.2015.04.014. Epub 2015 Apr 16.
To report the natural history and management outcomes of full-thickness macular hole (MH) caused by momentary exposure to a high-power handheld blue laser device and highlight the dangers of such easily available devices.
Retrospective consecutive case series.
A chart review of all patients presenting with full-thickness MH from exposure to blue-light high-powered lasers from January 2012 to May 2014 at 2 institutions was performed. Evaluation included a full ophthalmic examination, fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography. The main and secondary outcomes were MH closure and final visual acuity, respectively.
There were 17 eyes of 17 patients with full-thickness MH. Best-corrected Snellen visual acuity (BCVA) at presentation ranged from 20/30 to 2/200 (mean: 20/210). The MH minimum diameter ranged from 168 μm to 620 μm (mean: 351 μm). Fourteen eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas or silicone oil tamponade. Eleven of the 14 (78.6%) operated eyes had complete closure of the macular hole. Of the 3 unoperated eyes, only 1 eye with the smallest macular hole (minimum diameter: 168 μm) closed spontaneously with observation. Final BCVA in all cases had a mean of 20/62 (range: 20/20-4/200).
Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.
报告因瞬间暴露于高功率手持式蓝色激光设备而导致的全层黄斑裂孔（MH）的自然病程及治疗结果，并强调此类易于获取的设备的危险性。
回顾性连续病例系列。
对2012年1月至2014年5月在两家机构因暴露于蓝光高功率激光而出现全层MH的所有患者进行病历回顾。评估包括全面的眼科检查、眼底照相、黄斑区光谱域光学相干断层扫描和眼底荧光血管造影。主要和次要结果分别为黄斑裂孔闭合和最终视力。
17例患者共17只眼出现全层MH。就诊时最佳矫正视力（BCVA）范围为20/30至2/200（平均：20/210）。黄斑裂孔最小直径范围为168μm至620μm（平均：351μm）。14只眼接受了玻璃体切割术、内界膜剥除术以及气体或硅油填充。14只接受手术的眼中有11只（78.6%）黄斑裂孔完全闭合。3只未接受手术的眼中，仅1只黄斑裂孔最小（最小直径：168μm）的眼睛在观察过程中自发闭合。所有病例的最终BCVA平均为20/62（范围：20/20至4/200）。
瞬间暴露于高功率手持式激光设备可导致全层黄斑裂孔。虽然极少数情况下可能会自发闭合，但大多数病例需要早期手术干预。玻璃体切割术在大多数情况下可能成功闭合黄斑裂孔并提高视力。
