Spontaneous closure of macular holes in children

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Abstract

AIM: This study aimed to analyze clinical cases of spontaneous macular hole (MH) closure in children and determine the optimal approach for managing patients with this disease.

MATERIAL AND METHODS: Data from 32 patients aged 6–17 years (average: 11.3 years) were evaluated, including 32 eyes with a full thickness macular hole and 1 eye with a lamellar macular hole. All patients were treated in the Department of Pediatric Ocular Pathology of the Helmholtz National Medical Research Center of Eye Diseases in 2013–2023. They underwent a comprehensive ophthalmological examination, including optical coherence tomography (OCT) of the macular area.

RESULTS: Spontaneous MH closure was observed in five eyes (15.2%) of five patients (15.6%). The etiological factor of the disease was ocular contusion in two cases, photodamage in one case, and an inflammatory process in the posterior segment of the eye in two cases. A small diameter MH (100–261 µm) and its overgrowth soon after formation were common to all patients, that is, less than 2 months in 3 of 5 children and within 6 months in all patients.

CONCLUSION: Spontaneous closure of MH with a small diameter and in the early stages after its formation is rare in pediatric patients. For MH with a diameter of up to 200 µm according to OCT and the absence of other indications for surgical treatment, a wait-and-see approach for 3 months with regular (once a month) examination is recommended. In cases with MH closure tendency, continued follow-up is crucial; if it persists after 3 months or increases at any period of follow-up, surgical treatment is indicated.

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About the authors

Lyudmila A. Katargina

Helmholtz National Medical Research Center of Eye Diseases

Email: katargina@igb.ru
ORCID iD: 0000-0002-4857-0374

MD, Dr. Sci. (Med.), Professor

Russian Federation, 14/19, Sadovaya Chernogryazskaya Str., 105062 Moscow

Ekaterina V. Denisova

Helmholtz National Medical Research Center of Eye Diseases

Email: deale_2006@inbox.ru
ORCID iD: 0000-0003-3735-6249
SPIN-code: 4111-4330

MD, Cand. Sci. (Med.)

Russian Federation, 14/19, Sadovaya Chernogryazskaya Str., 105062 Moscow

Elena N. Demchenko

Helmholtz National Medical Research Center of Eye Diseases

Email: dem-andrej@yandex.ru
ORCID iD: 0000-0001-6523-5191

MD, Cand. Sci. (Med.)

Russian Federation, 14/19, Sadovaya Chernogryazskaya Str., 105062 Moscow

Natalya A. Osipova

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: natashamma@mail.ru
ORCID iD: 0000-0002-3151-6910
SPIN-code: 5872-6819

MD, Cand. Sci. (Med.)

Russian Federation, 14/19, Sadovaya Chernogryazskaya Str., 105062 Moscow

Maria V. Belova

Helmholtz National Medical Research Center of Eye Diseases

Email: mbelova.doc@gmail.com
ORCID iD: 0000-0001-6465-2313

MD, Cand. Sci. (Med.)

Russian Federation, 14/19, Sadovaya Chernogryazskaya Str., 105062 Moscow

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Supplementary files

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2. Fig. 1. Optical coherence tomogram of patient 1. Macular hole.

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3. Fig. 2. Optical coherence tomogram of patient 1 after macular hole closure.

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4. Fig. 3. Optical coherence tomogram of patient 2. Macular hole in the right eye retina.

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5. Fig. 4. Optical coherence tomogram of spontaneous closure of the right eye macular hole in patient 2, 2.5 months after macular hole detection.

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6. Fig. 5. Optical coherence tomogram of spontaneous closure of the right eye macular hole in patient 2, 12.5 months after macular hole detection.

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7. Fig. 6. Optical coherence tomogram of the macular zone of patient 3 upon admission.

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8. Fig. 7. Fundus (a) and optical coherence tomogram (b) of patient 3 with a formed macular hole.

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9. Fig. 8. Fundus image (a) and optical coherence tomogram (b) of patient 3. Improvement of macular hole closure.

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10. Fig. 9. Optical coherence tomogram of macular hole closure in patient 3.

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11. Fig. 10. Optical coherence tomogram of the macular zone of patient 4 after surgery.

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12. Fig. 11. Optical coherence tomogram of lamellar macular hole in patient 5.

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13. Fig. 12. Optical coherence tomogram of macular hole closure in patient 5.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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