Traumatic macular hole repair through topical dorzolamide: A case report
Abstract
Traumatic macular holes (MHs) still have a guarded prognosis. Whether spontaneous closure or early surgical intervention leads to a more favorable outcome is unclear. Topical therapy with carbonic anhydrase inhibitors was reported to be a non-invasive but effective treatment for traumatic MHs. A 17-year-old boy, whose face was injured by a firework explosion, presented to our emergency department with decreased vision in his left eye (20/125). A bio-microscopic examination revealed a vitreous hemorrhage that partially obscured the fundus. Optical coherence tomography (OCT) revealed an MH in the fovea with mild intra-retinal edema and juxtafoveal outer retinal layer alterations. Dorzolamide (2%) was administered four times per day. Two weeks later, OCT revealed a closed MH, and the patient's visual acuity had improved to 20/30 at 2 months following the incident. Topical aqueous suppression therapy may potentiate the closure of traumatic MHs by reducing the amount of intra-retinal fluid. It can serve as a non-invasive therapy for small traumatic MHs, especially those with the intra-retinal fluid, or as a temporary therapy before a scheduled operation.
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