Clinical features of traumatic macular holes secondary to globe contusion versus those secondary to blast-related ocular trauma
DOI:
https://doi.org/10.31288/Ukr.j.ophthalmol.202635560Keywords:
traumatic macular hole, blast-related trauma, globe contusion, macular hole, optical coherence tomography, vitrectomy, sclopetaria, retinaAbstract
Purpose. To examine the clinical features of traumatic macular holes (TMHs) secondary to globe contusion versus those secondary to blast-related ocular trauma (BROT) based on the review of medical records of patients visiting SI “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine” in 2018-2025.
Material and Methods. We retrospectively reviewed the medical records of 35 patients with TMH who underwent examination and treatment at SI “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine” in 2018-2025. Patients were divided into two groups based on the mechanism of trauma, with group 1 including 18 patients (18 eyes) with TMHs secondary to a closed-globe injury (namely, globe contusion), and group 2, 17 patients (17 eyes) with TMHs secondary to BROT.
Results. We found that TMHs secondary to globe contusion had a smaller size and an oval shape, and may spontaneously close, with better functional outcomes. TMHs secondary to BROT were relatively large and round, and were associated with isolated or multiple choroidal ruptures. The latter TMHs, when accompanied by subfoveally located choroidal ruptures, had lower visual acuity and limited improvement toward closure after surgical treatment. Surgery failed to achieve anatomical hole closure in two patients.
Conclusion. There are substantial differences in morphology, course, and visual prognosis of surgery between TMHs secondary to globe contusion and those secondary to BROT. The former are characterized by a more favorable clinical course, whereas the latter are accompanied by more severe ocular lesions, with lower visual function and the conditions creating a challenge in the diagnostic evaluation.
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