Đặc điểm lâm sàng của lỗ hoàng điểm do chấn thương đụng dập nhãn cầu

Abstract

By comparison to idiopathic macular hole, traumatic macular hole has distinctive clinical features, progression and prognosis. Patients with traumatic macular hole often are young people in working age and have low initial vision. Thanks to the development of OCT, we can observe, measure and calculate the parameters of the shape of traumatic macula which may be of prognostic values for treating traumatic macular hole. This is a prospective study aimed to describe the clinical characteristics of 33 eyes with traumatic macular hole caused by blunt injury. The average age of the patients was 27.33 ± 7.56 (years). All patients were male. The most common cause of injury was domestic accidents, accounting for 60,6%. Forty two percent of the patients were hospitalized 1 - 3 months after blunt injuries and a third (33.33%) came to hospital one year after blunt injuries. All patients had blurred vision; 78.8% experienced blurred vision immediately after injuries and 57.6% of the patients has visual acuity lower than 20/200, The best visual acuity among the patients was 20/80, More than half of the patients (54.6%) had the central subfield thickness less than 200 µm, 72.7% had apex diameter of the hole larger than 400 µm, 72.7% had basal diameter ranges from 1000 to 2000 µm. The macular hole index, which is ≥ 0,5, accounts for only 3%. The hole form factor, which is ≥ 0,9, accounts for 0%. The tractional hole index, which is ≤ 1.41, accounts for 100%. Complete posterior vitreous detachment occurred in 9.1% of the patients. The associated injuries included vitreous hemorrhage, lens subluxation, iridodial’s, retinal dialysis and enophthalmos. In conclusion, traumatic macular hole due to blunt injury seriously damages visual function. Poor initial vision, large diameter, measurable and calculatable OCT parameters may all lead to bad prognosis of the disease.