TRAUMATIC MACULAR HOLE IN SHAKEN BABY SYNDROME SUCCESSFULLY TREATED WITH PARS PLICATA VITRECTOMY AND GAS TAMPONADE

In Brief Purpose: To describe an infant with shaken baby syndrome and a traumatic macular hole treated with pars plana vitrectomy and gas tamponade. Design: Case report. Methods: A 4-month-old infant with suspected shaken baby syndrome presented with intraretinal and premacular hemorrhages. To prevent amblyopia, these hemorrhages were removed by pars plana vitrectomy, during which a full-thickness macular hole was discovered. Completion of a posterior vitreous detachment was not attempted at the time. Six months later, the macular hole remained open and was treated with pars plana vitrectomy, internal limiting membrane peeling, and perfluoropropane tamponade. Results: The procedure was well tolerated, and the macular hole closed without postoperative positioning. The hole remained closed 6 months after surgical repair. Conclusions: Traumatic macular hole may be a complication of shaken baby syndrome. This case demonstrates that pars plana vitrectomy with gas tamponade can be used to successfully treat traumatic macular hole in infants. The authors report an infant with a traumatic macular hole caused by shaken baby syndrome that was successfully treated with pars plicata vitrectomy and gas tamponade. In children, face-down positioning is difficult and consequently silicone oil is usually chosen for tamponade. In this case, hole closure did not require positioning.