Optical coherence tomography of the vitreoretinal interface in macular hole formation

• Published in: British journal of ophthalmology Vol. 85; no. 9; pp. 1092 - 1097
• Main Authors: Tanner, V, Chauhan, D S, Jackson, T L, Williamson, T H
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.09.2001; BMJ; BMJ Publishing Group LTD
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Classification; Development and progression; Eye diseases; Female; Fovea Centralis - pathology; Humans; hyaloid; Macular degeneration; macular hole; Male; Medical imaging; Medical sciences; Middle Aged; Ophthalmology; Optical tomography; Original articles - Clinical science; Pathogenesis; Prospective Studies; Retinal degeneration; Retinal Perforations - etiology; Retinal Perforations - pathology; Retinal Perforations - physiopathology; Retinopathies; Surgery; Tomography; Visual Acuity; Vitreous Body - pathology; United Kingdom; Human; Retinopathy; Radiodiagnosis; Pathogenesis; Idiopathic; Maculopathy; Eye; Macula; Eye disease; Macular hole; Light coherence; Tomography; Vitreoretinal; Formation; Interface
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.85.9.1092

AIMS To image the vitreoretinal interface and provide further information on the pathogenesis of idiopathic macular hole formation. METHODS Prospective recruitment of 80 eyes of 41 consecutive patients referred with a diagnosis of idiopathic full thickness macular hole (FTMH) to a teaching hospital retinal clinic. Both eyes of each patient underwent optical coherence tomography (OCT) imaging with vertical and horizontal scans centred on the fovea. RESULTS A total of 30 eyes had stage 2 or 3 FTMHs and, of these, 21 had persistent vitreofoveal attachment and associated prefoveal opacities. 18 prefoveal opacities were identified by Goldmann contact lens examination and confirmed on OCT examination. Three prefoveal opacities were identified only on OCT examination. 10 eyes had stage 4 FTMHs and four cases were identified in whom the OCT appearance was consistent with impending, aborted, or lamellar macular holes. CONCLUSIONS The wide range in OCT appearance of macular holes and associated prefoveal opacities suggests that, in at least some cases, a significant amount of retinal tissue is torn from the foveal area during macular hole formation. OCT imaging provides additional information on macular hole pathogenesis and is valuable in the planning of surgical intervention.