Search

Introduction Macular hemorrhages result in a sudden and profound loss of vision. The primary treatment modalities include observation, intravitreal injection of antiangiogenic drugs, neodymium-doped yttrium aluminum garnet hialoidotomy, intravitreal injection of gas with or without tissue plasminogen activator, as monotherapy or combined with surgery. In this paper, we report four cases of macular hemorrhages of different causes treated with different approaches, and we review the literature in this regard. Case presentation All four patients presented different causes of macular hemorrhage. The first case had a preretinal hemorrhage due to a Valsalva retinopathy and was treated with surgery. Case 2 had a multilevel macular hemorrhage due to a rupture of a retinal arteriolar macroaneurysm and was treated with pneumatic displacement, laser, and intravitreal ranibizumab. Case 3 presented an extensive subretinal hemorrhage due to a choroidal rupture after high-energy ocular trauma that was also successfully treated with surgery. The last case was a preretinal hemorrhage due to diabetic retinopathy managed with neodymium-doped yttrium aluminum garnet laser. Different treatment approaches were successfully performed in all cases with good outcomes. Conclusion There is an extensive range of options available for the management of macular hemorrhages, and the best option depends on the characteristics of each particular case. Proper and timely management of these diseases can achieve an excellent visual outcome, especially if the location of the hemorrhage is preretinal.

Background Determining the precise location of intraocular foreign bodies is crucial for the management of patients with open-globe injury. Computed tomography is the most common method for detecting intraocular foreign bodies in the posterior segment. In this article, we describe three cases of open-globe injury with different types of intraocular foreign bodies in the posterior segment that were accurately located using computed tomography scans and B-scan ultrasonography. Case presentation Each of the three cases of open-globe injury described in this report had different types of ocular trauma, clinical symptoms, and intraocular foreign bodies. Computed tomography scans showed the exact location of the intraocular foreign bodies in the posterior segment in two of the three cases. A B-scan ultrasound was used to determine the location of a non-metallic intraocular foreign body in the third case. All three patients had intraocular foreign bodies, and one of them had an additional orbital foreign body. Case 1 had a perforating eye injury with the additional intraorbital foreign body; Cases 2 and Case 3 had different types of intraocular foreign bodies and prognoses. Various treatment approaches were used, ranging from observation to surgery, depending on the location of the intraocular foreign bodies, and all cases were successfully managed. These three cases show that proper use of various types of imaging tests is indispensable in the context of an intraocular foreign body related to open-globe injury. Conclusion Imaging techniques are crucial for the detection of an intraocular foreign body, and computed tomography is one of the simplest and most useful, especially in cases of open-globe injury.

Del 1% al 9% de los traumas oculares contusos pueden acompañarse de un agujero macular traumático (AMT). Describimos un caso con resolución espontánea a los 11 días. Se presenta paciente masculino de 15 años de edad, con antecedente de trauma contuso en ojo izquierdo, con baja agudeza visual (AV) inmediata (2/200). se observa daño trabecular y un agujero macular completo, confirmado por OCT (373 micras de diámetro), el cual presenta aproximación de sus bordes hasta completar el cierre, presentando mejoría visual (20/250). Requirió cirugía filtrante para el control de la presión intraocular (PIO). Existen varios reportes de casos de cierre espontáneo de AMT, principalmente en pacientes jóvenes con agujeros pequeños. Existen varias teorías del mecanismo de cierre, el comportamiento del AMT en nuestro paciente podría confirmar 2 de estas teorías. En general, recuperan buena AV. Los AMT pueden presentar un cierre espontáneo dentro de los primeros 15 días hasta 9 meses posterior al traumatismo, por lo cual es importante realizar seguimiento clínico y por OCT durante este periodo, de esta manera nos permitirá tener mayor entendimiento de la fisiopatogenia del cierre del mismo y de los resultados anatómico-funcionales.