Traumatic macular hole revealing a retinitis pigmentosa: a case report

Abstract

Purpose To report a case of traumatic macular hole revealing a retinitis pigmentosa. Methods A 33‐year old man without past medical history complained of visual loss after direct trauma of his left eye. Visual acuity was 20/50 RE and 20/400 LE. Anterior chamber examination was normal and fundus examination revealed a large macular hole associated with optic atrophy in his left eye. Right eye funduscopy showed a cystoid macular edema and optic nerve palor (RE). Many pigment deposits were present in retinal mid‐periphery of both eyes. Optical coherence tomography showed cystoid macular edema (517 microns) RE and a large macular hole (3100 microns) LE. Typical visual field defects and extinguished electroretinogram responses confirmed the diagnosis of retinitis pigmentosa. Results Macular diseases are well‐known complications of retinitis pigmentosa, especially macular edema. Vitreomacular tractions, epiretinal membranes and macular holes are less frequent. These complications may be explained by pigment epithelium disorders that may compromise ionic drainage of the retina. Causes of macular hole in retinitis pigmentosa remain uncertain. In our patient, development of a macular hole may be explained by occurrence of trauma in an eye with pre‐existent macular edema secondary to the unknown retinitis pigmentosa. Conclusion Despite macular complications of retinitis pigmentosa are relatively common, a traumatic macular hole as a revealing symptom is exceptional.