TY - JOUR
T1 - Full-thickness macular hole secondary to high-power handheld blue laser
T2 - Natural history and management outcomes
AU - Alsulaiman, Sulaiman M.
AU - Alrushood, Abdulaziz Adel
AU - Almasaud, Jluwi
AU - Alkharashi, Abdullah S.
AU - Alzahrani, Yahya
AU - Abboud, Emad B.
AU - Nowilaty, Sawsan R.
AU - Arevalo, J. Fernando
AU - Al-Amry, Mohammad
AU - Alrashaed, Saba
AU - Ghazi, Nicola G.
AU - Al Kahtani, Eman
AU - Al Rashaed, Saba
AU - Al-Dhibi, Hassan A.
AU - Al-Zahrani, Yahya A.
AU - Kozak, Igor
AU - Al-Sulaiman, Sulaiman
AU - Al-Abdullah, Abdulelah
AU - Al-Bar, Ahmad
AU - Al Dhafiri, Yousef
AU - Al Qahtani, Abdullah
AU - Al Rubaie, Khalid
AU - Al Shahrani, Saeed
AU - Al Shehri, Maha
AU - Al Ahmadi, Badr
AU - Al Hadlaq, Abdulaziz
AU - Al Harbi, Majed
AU - Al Oreany, Abdulaziz
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Purpose To report the natural history and management outcomes of full-thickness macular hole (MH) caused by momentary exposure to a high-power handheld blue laser device and highlight the dangers of such easily available devices. Design Retrospective consecutive case series. Methods A chart review of all patients presenting with full-thickness MH from exposure to blue-light high-powered lasers from January 2012 to May 2014 at 2 institutions was performed. Evaluation included a full ophthalmic examination, fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography. The main and secondary outcomes were MH closure and final visual acuity, respectively. Results There were 17 eyes of 17 patients with full-thickness MH. Best-corrected Snellen visual acuity (BCVA) at presentation ranged from 20/30 to 2/200 (mean: 20/210). The MH minimum diameter ranged from 168 μm to 620 μm (mean: 351 μm). Fourteen eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas or silicone oil tamponade. Eleven of the 14 (78.6%) operated eyes had complete closure of the macular hole. Of the 3 unoperated eyes, only 1 eye with the smallest macular hole (minimum diameter: 168 μm) closed spontaneously with observation. Final BCVA in all cases had a mean of 20/62 (range: 20/20-4/200). Conclusion Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.
AB - Purpose To report the natural history and management outcomes of full-thickness macular hole (MH) caused by momentary exposure to a high-power handheld blue laser device and highlight the dangers of such easily available devices. Design Retrospective consecutive case series. Methods A chart review of all patients presenting with full-thickness MH from exposure to blue-light high-powered lasers from January 2012 to May 2014 at 2 institutions was performed. Evaluation included a full ophthalmic examination, fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography. The main and secondary outcomes were MH closure and final visual acuity, respectively. Results There were 17 eyes of 17 patients with full-thickness MH. Best-corrected Snellen visual acuity (BCVA) at presentation ranged from 20/30 to 2/200 (mean: 20/210). The MH minimum diameter ranged from 168 μm to 620 μm (mean: 351 μm). Fourteen eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas or silicone oil tamponade. Eleven of the 14 (78.6%) operated eyes had complete closure of the macular hole. Of the 3 unoperated eyes, only 1 eye with the smallest macular hole (minimum diameter: 168 μm) closed spontaneously with observation. Final BCVA in all cases had a mean of 20/62 (range: 20/20-4/200). Conclusion Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.
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U2 - 10.1016/j.ajo.2015.04.014
DO - 10.1016/j.ajo.2015.04.014
M3 - Article
C2 - 25892126
AN - SCOPUS:84930764169
VL - 160
SP - 107-113.e1
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 1
ER -