Spontaneous traumatic macular hole closure in a 50-year-old woman: a case report

• Main Authors: Rotsos Tryfon, Androudi Sofia, Tsinopoulos Ioannis, Symeonidis Chrysanthos, Nasr Mayssa B, Dimitrakos Stavros A
• Format: Article
• Language: English
• Published: BMC 2011-07-01
• Series: Journal of Medical Case Reports
• Online Access: http://www.jmedicalcasereports.com/content/5/1/290

<p>Abstract</p> <p>Introduction</p> <p>Traumatic macular holes (TMH) are well-known complications of ocular contusion injury. Spontaneous closure occurs in approximately 50% of cases, but rarely after the age of thirty. We report a case of spontaneous closure of a full thickness macular hole due to a blunt trauma and we suggest possible mechanisms for this closure.</p> <p>Case presentation</p> <p>A 50-year-old Greek woman was referred with a history of reduced best-corrected visual acuity after blunt trauma to her right eye. Diagnosis was based on fundoscopic, optical coherence tomography as well as fluorescein angiography findings with follow-up visits at two days, 20 days and five months. Fundoscopy revealed a full-thickness TMH with a minor sub-retinal hemorrhage and posterior vitreous detachment. The presence of a coagulum in the TMH base was observed. Subsequently, TMH closure was observed.</p> <p>Conclusion</p> <p>The clot in the TMH base, potentially a hemorrhage by-product containing a significant quantity of platelets, may have simulated the clot observed after autologous serum use, thus facilitating a similar effect. This may have stimulated glial cell migration and proliferation, thus contributing to spontaneous hole closure.</p>