PMC3263253_01
Posttraumatic macular hole-associated retinal detachment. Fundus photograph (a) and optical coherence tomography image (b). Microperimetry, done with four-cross target because of poor fixation, reveals loss of perceived stimuli at the macula (c). The macular hole is smaller and the detachment shallower after 3 days (d and e). Microperimetry shows absolute scotoma (f)
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F1
Clinically, a full-thickness MH, sized 415 mum, with coexistent macular detachment of height 458 mum on optical coherence tomography (OCT) examination (Stratus OCT, Carl Zeiss Meditec Inc., USA), was detected along with commotio retinae and widespread subretinal hemorrhages of the posterior pole and inferior retina [Fig. 1a and b]. SRL, Italy) demonstrated reduced sensitivity of the macula to high-intensity light stimuli [Fig. 1c]. Surgical intervention was contemplated. The height of the macular detachment had decreased to 420 mum [Fig. 1d and e].
Seven days later, the macular hole is closed and the subretinal fluid nearly completely absorbed (a and b). Examination by microperimetry remained the same (c). Three weeks later, the chorioretinal scarring is very prominent (d and e). Large atrophic holes in the inferior periphery were laser delimited (f)
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F2
Careful serial follow-up found complete closure of the MH and near complete resolution of the macular detachment 7 days after presentation [Fig. 2a and b]. Three weeks posttrauma, the chorioretinal scarring and pigmentary changes at the macula were very prominent [Fig. 2d]. Significant atrophy and thinning of all the retinal layers was evident on OCT examination; the foveal thickness was 82 mum [Fig. 2e]. Large atrophic holes were noticed at this time in the inferior retina and were delimited by laser photocoagulation [Fig. 2f].