Department of Vitreo-Retina Services, Aravind Eye Hospital and Post-graduate Institute of Ophthalmology, Coimbatore, India .
Retin Cases Brief Rep. 2021 Jul 1;15(4):373-375. doi: 10.1097/ICB.0000000000000830.
To report a case of idiopathic full-thickness macular hole in a young boy, which was managed surgically with good visual and anatomical outcomes.
Single case report.
An 8-year-old boy presented for defective vision in the left eye noticed for the past 2 weeks with best-corrected visual acuity of 6/24. A large full-thickness macular hole was diagnosed clinically and was confirmed on optical coherence tomography. There was no clinical or tomographic findings suggestive of trauma or retinal degeneration. After observation for 8 weeks, the patient underwent macular hole surgery in the left eye including internal limiting membrane peeling and C3F8 gas tamponade. Intraoperatively abnormally tight vitreoretinal adherence was noted during the induction of posterior vitreous detachment. Optical coherence tomography at 1 month after surgery showed decrease in the size of macular hole suggestive of incomplete closure. Repeat optical coherence tomography at 3 months showed closed macular hole with mild foveal thinning and ellipsoid zone discontinuity with best-corrected visual acuity improving to 6/18. The tomographic features and best-corrected visual acuity remained stable at 6-month follow-up.
We hereby report the first case, to the best of our knowledge, of a truly idiopathic full-thickness macular hole in an 8-year-old boy. Surgical treatment offers the best outcomes in these cases and should be considered at the earliest without waiting for spontaneous closure unlike in the case of traumatic full-thickness macular hole.
报告一例发生于年轻男孩的特发性全层黄斑裂孔病例,该患者接受了手术治疗,获得了良好的视力和解剖学结果。
单病例报告。
一名 8 岁男孩左眼视力下降就诊,其自觉症状出现于 2 周前,最佳矫正视力为 6/24。临床诊断为大的全层黄斑裂孔,并通过光学相干断层扫描(OCT)得到证实。无提示外伤或视网膜变性的临床或影像学表现。观察 8 周后,患者左眼接受了黄斑裂孔手术治疗,包括内界膜剥除和 C3F8 气体填充。术中在诱导玻璃体后脱离时发现异常紧密的玻璃体视网膜粘连。术后 1 个月 OCT 显示黄斑裂孔缩小,提示未完全闭合。术后 3 个月 OCT 显示黄斑裂孔闭合,伴有轻微中心凹变薄和椭圆体带不连续,最佳矫正视力提高至 6/18。6 个月随访时,影像学特征和最佳矫正视力保持稳定。
据我们所知,这是首例发生于 8 岁男孩的特发性全层黄斑裂孔病例。与外伤性全层黄斑裂孔不同,此类病例应尽早进行手术治疗,以期获得最佳效果,而不必等待其自然闭合。