PDF herunterladen
Klin Monbl Augenheilkd 2019; 236(08): 990-998
DOI: 10.1055/a-0608-4780
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Traumatisches Makulaforamen

Traumatic Macular Hole
Miltiadis Fiorentzis
1   Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale)
,
Berthold Seitz
2   Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg (Saar)
,
Arne Viestenz
1   Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale)
› Institutsangaben
Weitere Informationen

Publikationsverlauf

eingereicht 18. Februar 2018

akzeptiert 10. April 2018

Publikationsdatum:
13. Juli 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Zusammenfassung

Das traumatische Makulaforamen (TMF) ist eine seltene Komplikation nach Kontusionsverletzung oder offenem Bulbustrauma und kann zu permanentem Visusverlust führen. Der Pathomechanismus des TMF unterscheidet sich von demjenigen des idiopathischen Makulaforamens (IMF). Eine plötzliche Kompression und Expansion des Bulbus führt zu Glaskörpertraktionen, die in einem TMF resultieren können. Der finale Visus hängt vom Schweregrad der Disruption der Photorezeptoren und der retinalen Pigmentepithelzellen ab. Das posttraumatische Vorgehen wird kontrovers diskutiert. Ein spontaner Verschluss und ein konservatives Vorgehen sind bei jungen Patienten mit kleineren Defekten und gutem Visus ohne Anhebung des posterioren Glaskörpers abzuwägen. In diesen Fällen empfiehlt sich das Abwarten über Monate. Bei fehlender Adhäsion an den Rändern des Loches und begleitenden Pathologien des Pigmentepithels ist die Wahrscheinlichkeit einer spontanen Heilung gering. In diesem Fall kann eine Pars-plana-Vitrektomie mit Entfernung des Glaskörpers und der epiretinalen Membranen zur Wiederherstellung der Anatomie und zu einem Visusanstieg führen. Der Erfolg einer operativen Intervention ist multifaktoriell und ist mit der Erfahrung des Operateurs sowie mit den Charakteristika des Traumas assoziiert.

Abstract

The traumatic macular hole (TMH) is a rare complication of a blunt or an open injury of the globe and can lead to permanent loss of vision. The pathomechanism of TMH differs from that of the idiopathic macular hole (IMH). A sudden compression and expansion of the globe leads to vitreous traction, which can result in a TMH. The final visual acuity depends on the severity of the disruption of the photoreceptors and the retinal pigment epithelial cells. The posttraumatic approach is discussed controversially. A spontaneous closure and, therefore, a conservative approach should be considered in young patients with minor defects and good visual acuity without detachment of the posterior vitreous body. In these cases, it is advisable to wait for months. In the absence of adhesion at the edges of the hole and concomitant pathologies of the pigment epithelium, the spontaneous closure is improbable. In this case, a pars plana vitrectomy with removal of the vitreous and epiretinal membranes can lead to anatomical reconstruction and improvement of the visual acuity. The success of an operative intervention is complex and is associated with the experience of the surgeon as well as the characteristics of the trauma.

Schlüsselwörter

Trauma - ILM - Membrana limitans interna - Makulaforamen - Kontusion - Vitrektomie

Key words

trauma - ILM - inner limiting membrane - macular hole - contusion - vitrectomy
 

  • Literatur

  • 1 Kuhn F, Morris R, Witherspoon CD. et al. Epidemiology of blinding trauma in the United States Eye Injury Registry. Ophthalmic Epidemiol 2006; 13: 209-216
    CrossrefPubMedGoogle Scholar
  • 2 Viestenz A, Küchle M. Stumpfes Augentrauma. Teil II: Stumpfes Hinterabschnittstrauma. Ophthalmologe 2005; 102: 89-99
    CrossrefPubMedGoogle Scholar
  • 3 Johnson RN, McDonald HR, Lewis H. et al. Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery. Ophthalmology 2001; 108: 853-857
    CrossrefPubMedGoogle Scholar
  • 4 Fiorentzis M, Seitz B, Viestenz A. Traumatisches Makulaforamen mit zentraler Ablatio retinae und Aderhautruptur mit Oradialyse. Ophthalmologe 2015; 112: 682-685
    CrossrefPubMedGoogle Scholar
  • 5 Sanjay S, Yeo TK, Au Eong KG. Spontaneous closure of traumatic macular hole. J Ophthalmol 2012; 26: 343-345
    PubMedGoogle Scholar
  • 6 Huang J, Liu X, Wu Z. et al. Classification of full-thickness traumatic macular holes by optical coherence tomography. Retina 2009; 29: 340-348
    CrossrefPubMedGoogle Scholar
  • 7 Viestenz A, Fiorentzis M, Seitz B. Primäres Management offener Bulbusverletzungen. Klin Monatsbl Augenheilkd 2017; 234: 385-399
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 8 Yanagiya N, Akiba J, Takahashi M. et al. Clinical characteristics of traumatic macular holes. Jpn J Ophthalmol 1996; 40: 544-547
    PubMedGoogle Scholar
  • 9 Delori F, Pomerantzeff O, Cox MS. Deformation of the globe under high-speed impact: it relation to contusion injuries. Invest Ophthalmol 1969; 8: 290-301
    Google Scholar
  • 10 Brooks jr. HL. Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 2000; 107: 1939-1948
    CrossrefPubMedGoogle Scholar
  • 11 Tornambe P, Augustin AJ. Macular holes. Review of the current status of knowledge of pathogenesis and treatment methods. Ophthalmologe 2002; 99: 601-608
    CrossrefPubMedGoogle Scholar
  • 12 Coca M, Makkouk F, Picciani R. et al. Chronic traumatic giant macular hole repair with autologous platelets. Cureus 2017; 9: e955
    PubMedGoogle Scholar
  • 13 Gass JD. Idiopathic senile macular hole: its early stages and pathogenesis. Arch Ophthalmol 1988; 106: 629-639
    CrossrefPubMedGoogle Scholar
  • 14 Johnson RN, McDonald HR, Schatz H. et al. Outpatient postoperative fluid-gas exchange after early failed vitrectomy surgery for macular hole. Ophthalmology 1997; 104: 2009-2013
    CrossrefPubMedGoogle Scholar
  • 15 Ho AC, Guyer DR, Fine SL. Macular hole. Surv Ophthalmol 1998; 42: 393-416
    CrossrefPubMedGoogle Scholar
  • 16 Yamada H, Sakai A, Yamada E. et al. Spontaneous closure of traumatic macular hole. Am J Ophthalmol 2002; 134: 340-347
    CrossrefPubMedGoogle Scholar
  • 17 Yamashita T, Uemara A, Uchino E. et al. Spontaneous closure of traumatic macular hole. Am J Ophthalmol 2002; 133: 230-235
    CrossrefPubMedGoogle Scholar
  • 18 Coats G. The pathology of macular hole. Roy London Ophthalmic Hosp Rep 1907; 17: 69-96
    PubMedGoogle Scholar
  • 19 Lister W. Holes in the retina and their clinical significance. Br J Ophthalmol 1924; 8: 1-20
    CrossrefPubMedGoogle Scholar
  • 20 Yokotsuka K, Kishi S, Tobe K. et al. Clinical features of traumatic macular hole. Jpn J Ophthalmol 1991; 45: 1121-1124
    PubMedGoogle Scholar
  • 21 Courville CB. Coup-Contrecoup mechanism of craniocerebral injuries – some observations. Arch Surg 1942; 45: 19-43
    PubMedGoogle Scholar
  • 22 Wolter JR. Coup-Contrecoup mechanism of ocular injuries. Am J Ophthalmol 1963; 56: 785-796
    CrossrefPubMedGoogle Scholar
  • 23 Gass JD. Age-dependent idiopathic macular foramen. Current concepts of the pathogenesis, diagnosis, and treatment. Ophthalmologe 1995; 92: 617-625
    PubMedGoogle Scholar
  • 24 Duker JS, Kaiser PK, Binder S. et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013; 120: 2611-2619
    CrossrefPubMedGoogle Scholar
  • 25 Huang J, Liu X, Wu Z. et al. Classification of full-thickness traumatic macular holes by optical coherence tomography. Retina 2009; 29: 340-348
    CrossrefPubMedGoogle Scholar
  • 26 Arevalo JF, Sanchez JG, Costa RA. et al. Optical coherence tomography characteristics of full-thickness traumatic macular holes. Eye (Lond) 2008; 22: 1436-1441
    CrossrefPubMedGoogle Scholar
  • 27 Kusaka S, Fujikado T, Ikeda T. et al. Spontaneous disappearance of traumatic macular holes in young patients. Am J Ophthalmol 1997; 123: 837-839
    CrossrefPubMedGoogle Scholar
  • 28 Faghihi H, Ghassemi F, Falavarjani KG. et al. Spontaneous closure of traumatic macular holes. Can J Ophthalmol 2014; 49: 395-398
    CrossrefPubMedGoogle Scholar
  • 29 Liu W, Grzybowski A. Current management of traumatic macular holes. J Ophthalmol 2017; 2017: 1748135 doi:10.1155/2017/1748135
    PubMedGoogle Scholar
  • 30 Mitamura Y, Saito W, Ishida M. et al. Spontaneous closure of traumatic macular hole. Retina 2001; 21: 385-389
    CrossrefPubMedGoogle Scholar
  • 31 Miller JB, Yonekawa Y, Eliott D. et al. A review of traumatic macular hole: diagnosis and treatment. Int Ophthalmol Clin 2013; 53: 59-67
    PubMedGoogle Scholar
  • 32 Azevedo S, Ferreira N, Meireles A. Management of pediatric traumatic macular holes – case report. Case Rep Ophthalmol 2013; 4: 20-27
    CrossrefPubMedGoogle Scholar
  • 33 Takahashi H, Kishi S. Optical coherence tomography images of spontaneous macular hole closure. Am J Ophthalmol 1999; 128: 519-520
    CrossrefPubMedGoogle Scholar
  • 34 Knapp H. [About isolated ruptures of the choroid as a result of trauma to the eyeball]. Arch Augenheilkd 1869; 1: 6-29
    PubMedGoogle Scholar
  • 35 Noyes HD. Detachment of the retina with laceration at the macula lutea. Trans Am Ophthalmol Soc 1871; 1: 128-129
    PubMedGoogle Scholar
  • 36 Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Arch Ophthalmol 1991; 109: 654-659
    CrossrefPubMedGoogle Scholar
  • 37 Yuan LL, Han HD, Li XR. ClinicaI analysis of 47 cases with traumatic macular hole resulted from ocular contusion. Chin J Ocul Fund Dis 2015; 31: 45-48
    PubMedGoogle Scholar
  • 38 Hou J, Jiang YR. An analysis of the prognosis and factors of vitrectomy for a traumatic macular hole. Chin J Optom Ophthalmol Vis Sci 2013; 15: 26-29
    PubMedGoogle Scholar
  • 39 Kuhn F, Morris R, Mester V. et al. Internal limiting membrane removal for traumatic macular holes. Ophthalmic Surg Lasers 2001; 32: 308-315
    PubMedGoogle Scholar
  • 40 Miller JB, Yonekawa Y, Eliott D. et al. Long-term follow-up and outcomes in traumatic macular holes. Am J Ophthalmol 2015; 160: 1255-1258
    CrossrefPubMedGoogle Scholar
  • 41 Amari F, Ogino N, Matsumura M. et al. Vitreous surgery for traumatic macular holes. Retina 1999; 19: 410-413
    CrossrefPubMedGoogle Scholar
  • 42 Chow DR, Williams GA, Trese MT. et al. Successful closure of traumatic macular holes. Retina 1999; 19: 405-409
    CrossrefPubMedGoogle Scholar
  • 43 Gao M, Liu K, Lin Q. et al. Management modalities for traumatic macular hole: A systematic review and single-arm meta-analysis. Curr Eye Res 2017; 42: 287-296
    CrossrefPubMedGoogle Scholar
  • 44 Borʼi A, Al-Aswad MA, Saad AA. et al. Pars plana vitrectomy with internal limiting membrane peeling in traumatic macular hole: 14 % Perfluoropropane (C3F8) versus silicone oil tamponade. J Ophthalmol 2017; 2017: 3917696 doi:10.1155/2017/3917696
    PubMedGoogle Scholar
  • 45 Abou Shousha MA. Inverted internal limiting membrane flap for large traumatic macular holes. Medicine (Baltimore) 2016; 95: e2523
    PubMedGoogle Scholar
  • 46 Ghoraba HH, Ellakwa AF, Ghali AA. Long term result of silicone oil versus gas tamponade in the treatment of traumatic macular holes. Clin Ophthalmol 2012; 6: 49-53
    PubMedGoogle Scholar
  • 47 Tafoya ME, Lambert HM, Vu L. et al. Visual outcomes of silicone oil versus gas tamponade for macular hole surgery. Semin Ophthalmol 2003; 18: 127-131
    CrossrefPubMedGoogle Scholar
  • 48 Wachtlin J, Jandeck C, Potthöfer S. et al. Long-term results following pars plana vitrectomy with platelet concentrate in pediatric patients with traumatic macular hole. Am J Ophthalmol 2003; 136: 197-199
    CrossrefPubMedGoogle Scholar
  • 49 Wu WC, Drenser KA, Trese MT. et al. A pediatric traumatic macular hole: Results of autologous plasmin enzyme-assisted vitrectomy. Am J Ophthalmol 2007; 144: 668-672
    CrossrefPubMedGoogle Scholar
  • 50 Ikeda T, Sato K, Otani H. et al. Vitreous surgery combined with internal limiting membrane peeling for traumatic macular hole with severe retinal folds. Acta Ophthalmol Scand 2002; 80: 88-90
    CrossrefPubMedGoogle Scholar
  • 51 Barreau E, Massin P, Paques M. et al. [Surgical treatment of traumatic macular holes]. J Fr Ophtalmol 1997; 20: 423-429
    PubMedGoogle Scholar
  • 52 García-Arumí J, Corcostegui B, Cavero L. et al. The role of vitreoretinal surgery in the treatment of posttraumatic macular hole. Retina 1997; 17: 372-377
    CrossrefPubMedGoogle Scholar
  • 53 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. Ophthalmology 1995; 102: 1840-1845
    CrossrefPubMedGoogle Scholar
  • 54 Thompson JT, Smiddy WE, Williams GA. et al. Comparison of recombinant transforming growth factor-beta-2 and placebo as an adjunctive agent for macular hole surgery. Ophthalmology 1998; 105: 700-706
    CrossrefPubMedGoogle Scholar
  • 55 Stalmans P, Benz MS, Gandorfer A. et al. Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med 2012; 367: 606-615
    CrossrefPubMedGoogle Scholar