外伤性黄斑孔及自行闭合临床观察

目的观察外伤性黄斑孔的临床特点、自然预后及手术效果。方法2000年1月～2004年6月诊治的外伤性全层黄斑孔11例(11眼),随访6～42月;对其临床资料进行回顾性分析。结果11眼黄斑孔均由挫伤所致,其中9眼于外伤后即刻发生。随访过程中,3眼黄斑孔在外伤后3～l2周自行闭合,视力提高;3眼黄斑孔扩大,1眼视网膜脱离,发生时间均在外伤后3月,此4眼均进行了手术治疗,手术后视力提高;其余4眼黄斑孔大小无变化,视力稳定者,未做特殊处理,仍在继续观察中。结论外伤性黄斑孔自行闭合并不少见并且多发生在伤后早期。因此对视力稳定、孔径无扩大者,暂不手术而密切随访更好;对孔径扩大、视力下降者,手术治疗有利于黄斑孔的闭合和视力恢复。

Traumatic macular hole and its spontaneous closure

Objective To observe the clinical characteristics, prognosis and surgical results of traumatic macular hole. Methods From Jan. 2000 to Jun. 2004, 11 cases (11 eyes) of full-thickness traumatic macular hole were observed and treated. The follow-up time was 6-42 months. The clinical data were analyzed retrospectively. Results All of the macular holes were caused by contusion and most of them took place at the time of injury. During the follow-up, 3 of the macular holes closed spontaneously 3-12 months after trauma and visual acuity increased. Macular holes enlarged in 3 eyes and retinal detachment occurred in 1 eye, all of them appeared in the early 3 months after trauma and received surgical treatment. After surgery, 3 macular holes closed totally, 1 closed partly, and visual acuity improved in some degree. The other 4 eyes remained unchanged in diameter of macular hole and stable vision were not treated. Conclusion The early time after trauma, spontaneous closure of traumatic holes is not uncommon. For the patients with stable vision and unchanged holes, follow-up is more important than surgical repair.Otherwise, if macular holes become enlarged and vision decreased, surgical treatment is helpful for holes closing and improvement of vision