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Characteristics and surgical outcomes of pediatric traumatic macular holes
Ying Cui1, Ge Wang1, Xiangyu Shi2
1Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Lane, Dongcheng District, Beijing, 100730, China.
Insights
Vitrectomy effectively treats pediatric traumatic macular holes (MHs) from blunt trauma or laser pointers, improving vision. Larger hole size and blunt trauma predict poorer outcomes in pediatric macular hole surgery.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pediatric Eye Care
Background:
- Limited data exists on surgical outcomes for pediatric traumatic macular holes (MHs).
- Understanding characteristics and outcomes is crucial for effective treatment.
Purpose of the Study:
- To investigate the characteristics and surgical outcomes of pediatric traumatic MHs.
- To identify factors associated with surgical success in pediatric macular hole repair.
Main Methods:
- Retrospective analysis of 59 pediatric patients undergoing vitrectomy for traumatic MHs.
- Causes included blunt trauma (43 eyes) and laser pointer (16 eyes).
- Ophthalmic examinations and optical coherence tomography (OCT) were used for assessment.
Main Results:
- Overall MH closure rate was 89.8%.
- Good visual acuity responders (best corrected visual acuity [BCVA] ≥ 20/40) had smaller MHs and better preoperative BCVA.
- Blunt trauma injury was associated with poorer functional outcomes compared to laser pointer injury.
Conclusions:
- Vitrectomy is effective for pediatric traumatic MHs, achieving high closure rates and visual improvement.
- MH size is a key factor for anatomical success.
- Preoperative BCVA, MH size, and injury mechanism (blunt trauma) predict functional outcomes.
Background:
Due to the small number of cases, limited knowledge exists on the surgical outcome of pediatric traumatic macular holes (MHs). This study aims to investigate the characteristics and surgical outcomes of pediatric traumatic MHs and analyse the associated factors of surgical outcomes.
Methods:
59 pediatric patients that underwent vitrectomy for MHs caused by blunt trauma or laser pointer at a tertiary hospital were retrospectively recruited. Ophthalmic examination and optical coherence tomography were conducted at baseline and follow-ups.
Results:
The etiologies of the MHs were blunt trauma in 43 eyes and laser pointer in 16 eyes. The overall closure rate was 89.8%. MHs that did not close were larger than MHs that closed (P = 0.001). Among eyes with closed MHs, 41.5% achieved best corrected visual acuity (BCVA) of 20/40 or better (good responder). The good responders had better preoperative BCVA (P = 0.029), smaller minimal diameter (P < 0.001), and smaller preoperative ellipsoid zone defect (P = 0.002) than the poor responders (BCVA < 20/40). Patients hurt by blunt trauma were more likely to be poor responders than patients injured by laser pointer (P = 0.025, OR = 0.240, 95%CI: 0.066 ~ 0.866).
Conclusions:
Pediatric MHs could be caused by blunt trauma or laser pointer. Vitrectomy was effective in closing the holes and improving visual acuity. The anatomic outcome was related with MH size. Worse preoperative BCVA, larger MH size and blunt trauma injury were predictors of poor functional outcome.
