自然愈合与玻璃体切割手术治疗的外伤性黄斑裂孔患者临床特征及治疗方式选择研究现状_Chinese Journal of Ocular Fundus Diseases

Authors：

高敏 , 林秋蓉 ,  刘海芸

200080 上海交通大学附属第一人民医院眼科;

Corresponding author：

刘海芸, Email: 13901812628@163.com

Keywords：

视网膜穿孔/治疗; 玻璃体切除术; 综述

DOI：

10.3760/cma.j.issn.1005-1015.2015.05.032

Video：

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外伤性黄斑裂孔是指眼球在受到直接或者间接、闭合或者开放的外力创伤下立即或者延迟发生的黄斑部位裂孔。治疗主要有玻璃体切割手术和非手术观察治疗两种方式。根据其临床特征不同, 选择玻璃体切割手术或非手术观察治疗的主要考虑因素为患者年龄、黄斑裂孔大小、合并眼底损伤情况、患者身体基础疾病等。裂孔直径为0.2个视盘直径(DD)左右的患者, 裂孔自行闭合可能性大。观察1~6个月裂孔扩大、视力下降应及时终止观察改行手术治疗。裂孔直径在0.3 DD左右, 未合并眼底出血、视网膜脱离的年轻患者, 可优先考虑手术治疗, 争取获得较好的视力恢复。裂孔直径＞0.3 DD或者裂孔＜0.3 DD但合并眼底其他损伤的患者, 也可优先考虑手术治疗, 以其获得良好的裂孔闭合。

Citation： 高敏, 林秋蓉, 刘海芸. 自然愈合与玻璃体切割手术治疗的外伤性黄斑裂孔患者临床特征及治疗方式选择研究现状. Chinese Journal of Ocular Fundus Diseases, 2015, 31(5): 515-518. doi: 10.3760/cma.j.issn.1005-1015.2015.05.032 Copy

1.	Johnson RN, McDonald HR, Lewis H, et al. Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery[J]. Ophthalmology, 2001, 108(5): 853-857.
2.	Yamada H, Sakai A, Yamada E, et al. Spontaneous closure of traumatic macular hole[J].Am J Ophthalmol, 2002, 134(3):340-347.
3.	Sasahara M, Noami S, Takahashi M, et al. Optical coherence tomographic observations before and after macular hole formation secondary to laser injury[J]. Am J Ophthalmol, 2003, 136(6): 1167-1170.
4.	Kunjukunju N, Navarro A, Oliver S, et al. Bilateral macular hole formation secondary to sclopetaria caused by shockwaves transmitted by a posterior vector: case report[J]. BMC Ophthalmol, 2010, 10:6.
5.	Yamashita T, Uemara A, Uchino E, et al. Spontaneous closure of traumatic macular hole[J].Am J Ophthalmol, 2002, 133(2): 230-235.
6.	Kusaka S, Fujikado T, Ikeda T, et al. Spontaneous disappearance of traumatic macular holes in young patients[J]. Am J Ophthalmol, 1997, 123(6):837-839.
7.	Parmar DN, Stanga PE, Reck AC, et al.Imaging of a traumatic macular hole with spontaneous closure[J]. Retina, 1999, 19(5):470-472.
8.	Azevedo S, Ferreira N, Meireles A. Management of pediatric traumatic macular holes-case report[J]. Case Rep Ophthalmol, 2013, 4(2): 20-27.
9.	Menchini U, Virgili G, Giacomelli G, et al. Mechanism of spontaneous closure of traumatic macular hole: OCT study of one case[J]. Retina, 2003, 23(1):104-106.
10.	Karaca U, Durukan HA, Mumcuoglu T, et al. An unusual complication of blunt ocular trauma: a horseshoe-shaped macular tear with spontaneous closure[J]. Indian J Ophthalmol, 2014, 62(4):501-503.
11.	Ishida M, Takeuchi S, Okisaka S. Optical coherence tomography images of idiopathic macular holes with spontaneous closure[J]. Retina, 2004, 24(4):625-628.
12.	Arevalo JF, Sanchez JG, Costa RA, et al. Optical coherence tomography characteristics of full-thickness traumatic macular holes[J]. Eye (Lond), 2008, 22(11):1436-1441.
13.	Rubin JS, Glaser BM, Thompson JT, et al. Vitrectomy, fluid-gas exchange and transforming growth factor-beta-2 for the treatment of traumatic macular holes[J]. Ophthalmology, 1995, 102(12):1840-1845.
14.	Wachtlin J, Jandeck C, Potthofer S, et al. Long-term results following pars plana vitrectomy with platelet concentrate in pediatric patients with traumatic macular hole[J]. Am J Ophthalmol, 2003, 136(1):197-199.
15.	Chow DR, Williams GA, Trese MT, et al. Successful closure of traumatic macular holes[J].Retina, 1999, 19(5):405-409.
16.	Wu WC, Drenser KA, Trese MT, et al. Pediatric traumatic macular hole: results of autologous plasmin enzyme-assisted vitrectomy[J]. Am J Ophthalmol, 2007, 144(5):668-672.
17.	Margherio A. Plasmin enzyme-assisted vitrectomy in traumatic pediatric macular holes[J].Ophthalmology, 1998, 105(9):1617-1620.
18.	Ghoraba HH, Ellakwa AF, Ghali AA. Long term result of silicone oil versus gas tamponade in the treatment of traumatic macular holes[J]. Clin Ophthalmol, 2012, 6:49-53.
19.	Tafoya ME, Lambert HM, Vu L, et al. Visual outcomes of silicone oil versus gas tamponade for macular hole surgery[J]. Semin Ophthalmol, 2003, 18(3):127-131.
20.	Noyes HD. Detachment of retina with laceration at macula[J].Trans Am Ophthalmol Soc, 1871, 1(8):128-129.
21.	Amari F, Ogino N, Matsumura M, et al. Vitreous surgery for traumatic macular holes[J]. Retina, 1999, 19(5):410-413.
22.	Garcia-Arumi J, Corcostegui B, Cavero L, et al. The role of vitreoretinal surgery in the treatment of posttraumatic macular hole[J]. Retina, 1997, 17(5):372-377.
23.	Gass JD. Reappraisal of biomicroscopic classification of stages of development of a macular hole[J]. Am J Ophthalmol, 1995, 119(6):752-759.
24.	Ikeda T, Sato K, Otani H, et al. Vitreous surgery combined with internal limiting membrane peeling for traumatic macular hole with severe retinal folds[J]. Acta Ophthalmol Scand, 2002, 80(1):88-90.
25.	Hirata A, Tanihara H. Ruptured internal limiting membrane associated with blunt trauma revealed by indocyanine green staining[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(6):527-530.
26.	Kumar A, Wagh VB, Prakash G. et al. Visual outcome and electron microscopic features of indocyanine green-assisted internal limiting membrane peeling from macular hole of various aetiologies[J]. Indian J Ophthalmol, 2005, 53(3):159-165.
27.	Grosso A, Panico C.Panico Surgical management of sclopetaria associated with macular hole in a young patient: long term results[J]. Eye (Lond), 2009, 23(9):1875-1876.
28.	Chen YJ. Vitrectomy and internal limiting membrane peeling of a traumatic macular hole with retinal folds[J]. Case Rep Ophthalmol, 2011, 2(1):78-83.
29.	Goel N, Seth A, Kumar V, et al. Residual triamcinolone acetonide at macular hole after vitreous surgery[J].Indian J Ophthalmol, 2011, 59(3):264-266.
30.	Sayen A, Conart JB, Berrod JP. Posterior capsule rupture, iridodialysis, hyphema, and macular hole after blunt ocular trauma[J]. J Fr Ophtalmol, 2013, 36(10):187-190.
31.	Rajagopal J, Shetty SB, Kamath AG, et al. Macular hole following electrical shock injury[J].Can J Ophthalmol, 2010, 45(2):187-188.
32.	Yeshurun I, Guerrero-Naranjo JL, Quiroz-Mercado H. Spontaneous closure of a large traumatic macular hole in a young patient[J]. Am J Ophthalmol, 2002, 134(4):602-603.
33.	Lai MM, Joshi MM, Trese MT. Spontaneous resolution of traumatic macular hole-related retinal detachment[J]. Am J Ophthalmol, 2006, 141(6):1148-1151.
34.	Bosch-Valero J, Mateo J, Lavilla-Garcia L, et al.Spontaneous closure of full thickness traumatic macular holes[J]. Arch Soc Esp Oftalmol, 2008, 83(5):325-327.
35.	Nasr M B, Symeonidis C, Tsinopoulos I, et al. Spontaneous traumatic macular hole closure in a 50-year-old woman: a case report[J].J Med Case Rep, 2011, 5:290.
36.	Sanjay S, Yeo TK, Au Eong KG. Spontaneous closure of traumatic macular hole[J]. Saudi J Ophthalmol, 2012, 26(3):343-345.
37.	Sartori Jde F, Stefanini F, Moraes NS.Spontaneous closure of pediatric traumatic macular hole: case report and spectral-domain OCT follow-up[J]. Arq Bras Oftalmol, 2012, 75(4):286-288.
38.	Faghihi H, Ghassemi F, Falavarjani KG, et al. Spontaneous closure of traumatic macular holes[J].Can J Ophthalmol, 2014, 49(4):395-398.
39.	Papazoglou A, Baumuller S, Meyer C. Smartphone-operated detonation of a firecracker resulting in a macular hole[J]. Ophthalmologe, 2014, 111(11):1070-1072.
40.	Aalok L, Azad R, Sharma YR, et al. Microperimetry and optical coherence tomography in a case of traumatic macular hole and associated macular detachment with spontaneous resolution[J]. Indian J Ophthalmol, 2012, 60(1):66-68.
41.	李学伟, 卢宁, 张兰, 等.外伤性黄斑裂孔的随诊观察[J].中华眼科杂志, 2008, 44(9):786-789.
42.	Phillips BN, Chun DW, Colyer M. Closed globe macular injuries after blasts in combat[J]. Retina, 2013, 33(2):371-379.
43.	Brasil OF, Brasil OM.Management of traumatic macular holes: case report[J]. Arq Bras Oftalmol, 2008, 71(4):581-584.
44.	Rishi P, Reddy S, Rishi E. Delayed, spontaneous conversion of type 2 closure to type 1 closure following surgery for traumatic macular hole associated with submacular hemorrhage[J]. Oman J Ophthalmol, 2012, 5(3):189-190.

1. Johnson RN, McDonald HR, Lewis H, et al. Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery[J]. Ophthalmology, 2001, 108(5): 853-857.
2. Yamada H, Sakai A, Yamada E, et al. Spontaneous closure of traumatic macular hole[J].Am J Ophthalmol, 2002, 134(3):340-347.
3. Sasahara M, Noami S, Takahashi M, et al. Optical coherence tomographic observations before and after macular hole formation secondary to laser injury[J]. Am J Ophthalmol, 2003, 136(6): 1167-1170.
4. Kunjukunju N, Navarro A, Oliver S, et al. Bilateral macular hole formation secondary to sclopetaria caused by shockwaves transmitted by a posterior vector: case report[J]. BMC Ophthalmol, 2010, 10:6.
5. Yamashita T, Uemara A, Uchino E, et al. Spontaneous closure of traumatic macular hole[J].Am J Ophthalmol, 2002, 133(2): 230-235.
6. Kusaka S, Fujikado T, Ikeda T, et al. Spontaneous disappearance of traumatic macular holes in young patients[J]. Am J Ophthalmol, 1997, 123(6):837-839.
7. Parmar DN, Stanga PE, Reck AC, et al.Imaging of a traumatic macular hole with spontaneous closure[J]. Retina, 1999, 19(5):470-472.
8. Azevedo S, Ferreira N, Meireles A. Management of pediatric traumatic macular holes-case report[J]. Case Rep Ophthalmol, 2013, 4(2): 20-27.
9. Menchini U, Virgili G, Giacomelli G, et al. Mechanism of spontaneous closure of traumatic macular hole: OCT study of one case[J]. Retina, 2003, 23(1):104-106.
10. Karaca U, Durukan HA, Mumcuoglu T, et al. An unusual complication of blunt ocular trauma: a horseshoe-shaped macular tear with spontaneous closure[J]. Indian J Ophthalmol, 2014, 62(4):501-503.
11. Ishida M, Takeuchi S, Okisaka S. Optical coherence tomography images of idiopathic macular holes with spontaneous closure[J]. Retina, 2004, 24(4):625-628.
12. Arevalo JF, Sanchez JG, Costa RA, et al. Optical coherence tomography characteristics of full-thickness traumatic macular holes[J]. Eye (Lond), 2008, 22(11):1436-1441.
13. Rubin JS, Glaser BM, Thompson JT, et al. Vitrectomy, fluid-gas exchange and transforming growth factor-beta-2 for the treatment of traumatic macular holes[J]. Ophthalmology, 1995, 102(12):1840-1845.
14. Wachtlin J, Jandeck C, Potthofer S, et al. Long-term results following pars plana vitrectomy with platelet concentrate in pediatric patients with traumatic macular hole[J]. Am J Ophthalmol, 2003, 136(1):197-199.
15. Chow DR, Williams GA, Trese MT, et al. Successful closure of traumatic macular holes[J].Retina, 1999, 19(5):405-409.
16. Wu WC, Drenser KA, Trese MT, et al. Pediatric traumatic macular hole: results of autologous plasmin enzyme-assisted vitrectomy[J]. Am J Ophthalmol, 2007, 144(5):668-672.
17. Margherio A. Plasmin enzyme-assisted vitrectomy in traumatic pediatric macular holes[J].Ophthalmology, 1998, 105(9):1617-1620.
18. Ghoraba HH, Ellakwa AF, Ghali AA. Long term result of silicone oil versus gas tamponade in the treatment of traumatic macular holes[J]. Clin Ophthalmol, 2012, 6:49-53.
19. Tafoya ME, Lambert HM, Vu L, et al. Visual outcomes of silicone oil versus gas tamponade for macular hole surgery[J]. Semin Ophthalmol, 2003, 18(3):127-131.
20. Noyes HD. Detachment of retina with laceration at macula[J].Trans Am Ophthalmol Soc, 1871, 1(8):128-129.
21. Amari F, Ogino N, Matsumura M, et al. Vitreous surgery for traumatic macular holes[J]. Retina, 1999, 19(5):410-413.
22. Garcia-Arumi J, Corcostegui B, Cavero L, et al. The role of vitreoretinal surgery in the treatment of posttraumatic macular hole[J]. Retina, 1997, 17(5):372-377.
23. Gass JD. Reappraisal of biomicroscopic classification of stages of development of a macular hole[J]. Am J Ophthalmol, 1995, 119(6):752-759.
24. Ikeda T, Sato K, Otani H, et al. Vitreous surgery combined with internal limiting membrane peeling for traumatic macular hole with severe retinal folds[J]. Acta Ophthalmol Scand, 2002, 80(1):88-90.
25. Hirata A, Tanihara H. Ruptured internal limiting membrane associated with blunt trauma revealed by indocyanine green staining[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(6):527-530.
26. Kumar A, Wagh VB, Prakash G. et al. Visual outcome and electron microscopic features of indocyanine green-assisted internal limiting membrane peeling from macular hole of various aetiologies[J]. Indian J Ophthalmol, 2005, 53(3):159-165.
27. Grosso A, Panico C.Panico Surgical management of sclopetaria associated with macular hole in a young patient: long term results[J]. Eye (Lond), 2009, 23(9):1875-1876.
28. Chen YJ. Vitrectomy and internal limiting membrane peeling of a traumatic macular hole with retinal folds[J]. Case Rep Ophthalmol, 2011, 2(1):78-83.
29. Goel N, Seth A, Kumar V, et al. Residual triamcinolone acetonide at macular hole after vitreous surgery[J].Indian J Ophthalmol, 2011, 59(3):264-266.
30. Sayen A, Conart JB, Berrod JP. Posterior capsule rupture, iridodialysis, hyphema, and macular hole after blunt ocular trauma[J]. J Fr Ophtalmol, 2013, 36(10):187-190.
31. Rajagopal J, Shetty SB, Kamath AG, et al. Macular hole following electrical shock injury[J].Can J Ophthalmol, 2010, 45(2):187-188.
32. Yeshurun I, Guerrero-Naranjo JL, Quiroz-Mercado H. Spontaneous closure of a large traumatic macular hole in a young patient[J]. Am J Ophthalmol, 2002, 134(4):602-603.
33. Lai MM, Joshi MM, Trese MT. Spontaneous resolution of traumatic macular hole-related retinal detachment[J]. Am J Ophthalmol, 2006, 141(6):1148-1151.
34. Bosch-Valero J, Mateo J, Lavilla-Garcia L, et al.Spontaneous closure of full thickness traumatic macular holes[J]. Arch Soc Esp Oftalmol, 2008, 83(5):325-327.
35. Nasr M B, Symeonidis C, Tsinopoulos I, et al. Spontaneous traumatic macular hole closure in a 50-year-old woman: a case report[J].J Med Case Rep, 2011, 5:290.
36. Sanjay S, Yeo TK, Au Eong KG. Spontaneous closure of traumatic macular hole[J]. Saudi J Ophthalmol, 2012, 26(3):343-345.
37. Sartori Jde F, Stefanini F, Moraes NS.Spontaneous closure of pediatric traumatic macular hole: case report and spectral-domain OCT follow-up[J]. Arq Bras Oftalmol, 2012, 75(4):286-288.
38. Faghihi H, Ghassemi F, Falavarjani KG, et al. Spontaneous closure of traumatic macular holes[J].Can J Ophthalmol, 2014, 49(4):395-398.
39. Papazoglou A, Baumuller S, Meyer C. Smartphone-operated detonation of a firecracker resulting in a macular hole[J]. Ophthalmologe, 2014, 111(11):1070-1072.
40. Aalok L, Azad R, Sharma YR, et al. Microperimetry and optical coherence tomography in a case of traumatic macular hole and associated macular detachment with spontaneous resolution[J]. Indian J Ophthalmol, 2012, 60(1):66-68.
41. 李学伟, 卢宁, 张兰, 等.外伤性黄斑裂孔的随诊观察[J].中华眼科杂志, 2008, 44(9):786-789.
42. Phillips BN, Chun DW, Colyer M. Closed globe macular injuries after blasts in combat[J]. Retina, 2013, 33(2):371-379.
43. Brasil OF, Brasil OM.Management of traumatic macular holes: case report[J]. Arq Bras Oftalmol, 2008, 71(4):581-584.
44. Rishi P, Reddy S, Rishi E. Delayed, spontaneous conversion of type 2 closure to type 1 closure following surgery for traumatic macular hole associated with submacular hemorrhage[J]. Oman J Ophthalmol, 2012, 5(3):189-190.

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Chinese Journal of Ocular Fundus Diseases

自然愈合与玻璃体切割手术治疗的外伤性黄斑裂孔患者临床特征及治疗方式选择研究现状

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