Delayed spontaneous closure of traumatic macular hole in a 66-year-old patient – role of optical coherence tomography follow-up

Objective: To report a case of delayed spontaneous closure of traumatic macular hole at 5 months in a 66-year-old man. Traumatic macular holes generally do not close spontaneously after 4 months and over 30 years of age. Methods: A 66-year-old man presented with central blurred vision and metamorphopsia in his right eye for 3 weeks after previous ocular blunt trauma occurring 2 months earlier. Best corrected visual acuity was 6/36 in his right eye, fundus examination and OCT revealed right traumatic macular hole. Results: 4 weeks later, best corrected visual acuity was 6/18, OCT showed initial reattachment of traumatic macular hole margins. 8 weeks later, best corrected visual acuity improved to 6/9, OCT showed almost complete reattachment of the margins, residual outer retinal defect being still present. At 12 weeks after initial presentation, best corrected visual acuity was 6/6, OCT showed normal neuroretinal profile. Conclusion: Clinical monitoring of traumatic macular holes might be performed up to 5 months even in patients >30 years before considering surgery.