Open AccessDelayed, spontaneous conversion of type 2 closure to type 1 closure following surgery for traumatic macular hole associated with submacular hemorrhage
Author(s) -
Pukhraj Rishi,
Sumanth Reddy,
Ekta Rishi
Publication year - 2012
Publication title -
oman journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.306
H-Index - 16
eISSN - 0974-7842
pISSN - 0974-620X
DOI - 10.4103/0974-620x.106105
Subject(s) - medicine , macular hole , vitrectomy , visual acuity , ophthalmology , internal limiting membrane , fundus (uterus) , optical coherence tomography , surgery
A 45-year-old man presented with diminution of vision in the left eye following a firecracker injury. Best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/125 in the left eye. Fundus examination revealed vitreous hemorrhage, a macular hole, and submacular hemorrhage in the left eye. The patient underwent vitrectomy, tissue plasminogen activator (tPA)-assisted evacuation of the submacular hemorrhage, internal limiting membrane (ILM) peeling, and 14% C3F8 gas insufflation. After two months, the BCVA remained 20/125 and optical coherence tomography (OCT) showed type 2 macular hole closure. On a follow-up, seven months after surgery, BCVA improved to 20/80, N6, with type 1 closure of the macular hole. The clinical findings were confirmed on OCT. Delayed and spontaneous conversion of the traumatic macular hole could occur several months after the primary surgery and may be associated with improved visual outcome. Larger studies are required to better understand the factors implicated in such a phenomenon.