Observation of the development and spontaneous closure of a traumatic macular hole by optical coherence tomography

Abstract

We report a case of a traumatic macular hole (TMH) formation which occurred several days after a blunt trauma in a child in order to demonstrate its spontaneous closure by daily optical coherence tomography (OCT) findings. A nine-year-old boy applied to the outpatient clinic with skin injury in the zygoma region which was caused by blunt trauma. Foveal contour was normal and subretinal and intraretinal fluid was detected on OCT. On the 2nd day, the subretinal fluid increased. On the 3rd day, there was a slight separation between the outer plexiform layer and the outer nuclear layer, suggesting a lamellar hole. A full-thickness macular hole with a base width of 360 microns was observed on the 7th day. On the 3rd week of follow-up, the OCT revealed closure of macular hole. A slight foveal depression and highly reflective accumulation and shadowing of retinal pigment epithelium were detected. A spontaneous closure may be observed in TMHs, especially in patients within the pediatric age group. Observation may be a better therapeutic option for TMHs before deciding on a macular surgery in childhood.