外伤性黄斑全层裂孔的OCT观察

Observation of full-thickness traumatic macular hole ：with the optical coherence tomography

目的观察外伤性黄斑全层裂孔的光学相干断层成像特征及转归。方法对15例（15只眼）黄斑全层裂孔患者采用OCT检查观察两周至2年，分析其图像特征。结果15只眼OCT图像均表现为黄斑区全层视网膜神经上皮缺失；15只眼中11例未进行手术治疗，其中4例在2周至8个月（36．4％）自然愈合，视力平均提高3．3行。6例（54．5％）观察了6个月至2年未愈合，视力提高1～2行者5例，下降者1例。1例（9．1％）在受伤后1～7个月期间发展成为全层裂孔，视力无明显变化；15只眼中4例进行了手术治疗，术后2个月至1年OCT显示裂孔愈合，2例视力提高了3行，2例视力无明显改善。结论外伤性黄斑全层裂孔是有可能自然愈合的，采用OCT保守观察是外伤性黄斑裂孔治疗的一种选择。

Objective To observe the optical coherence tomography（OCT）characteristics of patients with full-thickness traumatic macular hole （TMH）and its outcomes.Methods Fifteen patients who suffered from unilateral TMH were followed up for 2 weeks to2 years after the OCT examination, in order to analyze their OCT characteristics and the outcomes of the disease.Results All 15 eyes showed manifestations of full-thickness loss of retinal neural epithelium on OCT.Eleven eyes were without surgery,in which 4 eyes （36.4%）had spontaneous closure with average improvement of 3.3 rows in visual acuity;6 （54.5%）holes in 6 eyes did not close, with visual acuity improvement of 1-2 rows in 5 eyes and decline in 1 eye.One eye （9.1% ） developed to be full-thickness hole 1 to 7 months after trauma without obvious change of visual acuity.Four eyes had been under surgery of vitrectomy, the holes all closed as shown on OCT; in which 2 eyes showed visual acuity improvement of 2 rows or higher, but no obvious improvement in the other 2 eyes.Conclusion Full-thickness traumatic macular hole is likely to close up spontaneously.Observation for a period with OCT may be a choice for TMH.