Dear Editor,
We went through the article titled “Traumatic macular hole repair through topical dorzolamide: A case report” by Huang et al.[1] We have a few observations. A closer look at the initial optical coherence tomography (OCT) scan provided shows a tissue bridging the roof of the macular hole. Minimal intra-retinal fluid and absence of intra-retinal cystic spaces can also be noted on the OCT scan. It is likely that the hole was already undergoing spontaneous healing and closure at the time the scan was done. It will be interesting to know the duration between the injury and presentation to the Ophthalmology Department which has not been mentioned in the article.
Traumatic macular holes tend to form immediately after the trauma. Hydration of the retinal tissue has been postulated to be playing a role in macular hole formation in addition to the tangential vitreoretinal tractional forces.[2] The dehydrating effect of carbonic anhydrase inhibitors is considered to be playing a role in macular hole closure. Spontaneous hole closures are more likely to happen in holes without any intra-retinal cysts.[3] The present case had no intra-retinal cysts which is another point in favour of a spontaneous closure. We feel that in this case the hole would have closed spontaneously even if Dorzolamide was not used. There are reports that such holes can spontaneously re-open in the future.[4] Therefore, the patient needs to be asked to come for regular follow-ups.
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References
- 1.Huang HA, Chen KJ, Lai CC, Chou HD. Traumatic macular hole repair through topical dorzolamide: A case report. Indian J Ophthalmol Case Rep. 2023;3:415–8. [Google Scholar]
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