Spontaneous closure of a large traumatic macular hole in a young patient

PURPOSE: To report the spontaneous resolution of a traumatic macular hole that was considerably larger than in previously reported cases. DESIGN: Observational case report METHODS: The clinical and angiographic data of the patient were reviewed. RESULTS: A traumatic 600 X 400 v macular hole was observed to spontaneously resolve 5 weeks after trauma in a 15-year-old patient. Visual acuity only slightly improved consequently (from counting fingers at 4 meters to 20/200). The clinical appearance of the fovea after macular hole resolution raised the suggestion that a postconcussion retinal necrosis was the mechanism be. hind the lesion formation in this case. CONCLUSIONS: Spontaneous resolution of a traumatic macular hole is an outcome not limited to small lesions. Larger macular holes may represent retinal tissue loss and consequently a less favorable visual prognosis. (C) 2002 by Elsevier Science Inc. All rights reserved.