Full-thickness macular hole secondary to high-power handheld blue laser: Natural history and management outcomes

Sulaiman M. Alsulaiman, Abdulaziz Adel Alrushood, Jluwi Almasaud, Abdullah S. Alkharashi, Yahya Alzahrani, Emad B. Abboud, Sawsan R. Nowilaty, J Fernando Arevalo, Mohammad Al-Amry, Saba Alrashaed, Nicola G. Ghazi, Eman Al Kahtani, Saba Al Rashaed, Hassan A. Al-Dhibi, Yahya A. Al-Zahrani, Igor Kozak, Sulaiman Al-Sulaiman, Abdulelah Al-Abdullah, Ahmad Al-Bar, Yousef Al DhafiriAbdullah Al Qahtani, Khalid Al Rubaie, Saeed Al Shahrani, Maha Al Shehri, Badr Al Ahmadi, Abdulaziz Al Hadlaq, Majed Al Harbi, Abdulaziz Al Oreany

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)107-113.e1
JournalAmerican Journal of Ophthalmology
Volume160
Issue number1
DOIs
StatePublished - Jul 1 2015

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Retinal Perforations
Natural History
Lasers
Visual Acuity
Vitrectomy
Equipment and Supplies
Silicone Oils
Temazepam
Fluorescein Angiography
Photography
Optical Coherence Tomography
Gases
Observation
Light
Membranes

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Alsulaiman, S. M., Alrushood, A. A., Almasaud, J., Alkharashi, A. S., Alzahrani, Y., Abboud, E. B., ... Al Oreany, A. (2015). Full-thickness macular hole secondary to high-power handheld blue laser: Natural history and management outcomes. American Journal of Ophthalmology, 160(1), 107-113.e1. https://doi.org/10.1016/j.ajo.2015.04.014

Full-thickness macular hole secondary to high-power handheld blue laser : Natural history and management outcomes. / Alsulaiman, Sulaiman M.; Alrushood, Abdulaziz Adel; Almasaud, Jluwi; Alkharashi, Abdullah S.; Alzahrani, Yahya; Abboud, Emad B.; Nowilaty, Sawsan R.; Arevalo, J Fernando; Al-Amry, Mohammad; Alrashaed, Saba; Ghazi, Nicola G.; Al Kahtani, Eman; Al Rashaed, Saba; Al-Dhibi, Hassan A.; Al-Zahrani, Yahya A.; Kozak, Igor; Al-Sulaiman, Sulaiman; Al-Abdullah, Abdulelah; Al-Bar, Ahmad; Al Dhafiri, Yousef; Al Qahtani, Abdullah; Al Rubaie, Khalid; Al Shahrani, Saeed; Al Shehri, Maha; Al Ahmadi, Badr; Al Hadlaq, Abdulaziz; Al Harbi, Majed; Al Oreany, Abdulaziz.

In: American Journal of Ophthalmology, Vol. 160, No. 1, 01.07.2015, p. 107-113.e1.

Research output: Contribution to journalArticle

Alsulaiman, SM, Alrushood, AA, Almasaud, J, Alkharashi, AS, Alzahrani, Y, Abboud, EB, Nowilaty, SR, Arevalo, JF, Al-Amry, M, Alrashaed, S, Ghazi, NG, Al Kahtani, E, Al Rashaed, S, Al-Dhibi, HA, Al-Zahrani, YA, Kozak, I, Al-Sulaiman, S, Al-Abdullah, A, Al-Bar, A, Al Dhafiri, Y, Al Qahtani, A, Al Rubaie, K, Al Shahrani, S, Al Shehri, M, Al Ahmadi, B, Al Hadlaq, A, Al Harbi, M & Al Oreany, A 2015, 'Full-thickness macular hole secondary to high-power handheld blue laser: Natural history and management outcomes', American Journal of Ophthalmology, vol. 160, no. 1, pp. 107-113.e1. https://doi.org/10.1016/j.ajo.2015.04.014
Alsulaiman, Sulaiman M. ; Alrushood, Abdulaziz Adel ; Almasaud, Jluwi ; Alkharashi, Abdullah S. ; Alzahrani, Yahya ; Abboud, Emad B. ; Nowilaty, Sawsan R. ; Arevalo, J Fernando ; Al-Amry, Mohammad ; Alrashaed, Saba ; Ghazi, Nicola G. ; Al Kahtani, Eman ; Al Rashaed, Saba ; Al-Dhibi, Hassan A. ; Al-Zahrani, Yahya A. ; Kozak, Igor ; Al-Sulaiman, Sulaiman ; Al-Abdullah, Abdulelah ; Al-Bar, Ahmad ; Al Dhafiri, Yousef ; Al Qahtani, Abdullah ; Al Rubaie, Khalid ; Al Shahrani, Saeed ; Al Shehri, Maha ; Al Ahmadi, Badr ; Al Hadlaq, Abdulaziz ; Al Harbi, Majed ; Al Oreany, Abdulaziz. / Full-thickness macular hole secondary to high-power handheld blue laser : Natural history and management outcomes. In: American Journal of Ophthalmology. 2015 ; Vol. 160, No. 1. pp. 107-113.e1.
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abstract = "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.",
author = "Alsulaiman, {Sulaiman M.} and Alrushood, {Abdulaziz Adel} and Jluwi Almasaud and Alkharashi, {Abdullah S.} and Yahya Alzahrani and Abboud, {Emad B.} and Nowilaty, {Sawsan R.} and Arevalo, {J Fernando} and Mohammad Al-Amry and Saba Alrashaed and Ghazi, {Nicola G.} and {Al Kahtani}, Eman and {Al Rashaed}, Saba and Al-Dhibi, {Hassan A.} and Al-Zahrani, {Yahya A.} and Igor Kozak and Sulaiman Al-Sulaiman and Abdulelah Al-Abdullah and Ahmad Al-Bar and {Al Dhafiri}, Yousef and {Al Qahtani}, Abdullah and {Al Rubaie}, Khalid and {Al Shahrani}, Saeed and {Al Shehri}, Maha and {Al Ahmadi}, Badr and {Al Hadlaq}, Abdulaziz and {Al Harbi}, Majed and {Al Oreany}, Abdulaziz",
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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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