Abstract:
PURPOSE:To describe the morphologic and anatomic relationships at the vitreoretinal interface, from the macula into the periphery, in patients with idiopathic macular hole. Montaged images of posterior and peripheral spectral-domain (SD) optical coherence tomography (OCT) studies were used to describe the anatomic vitreoretinal relationships. DESIGN:Prospective, consecutive, observational case series. PARTICIPANTS:Forty-six eyes of thirty-six consecutive patients with idiopathic macular hole and their fellow eyes. METHODS:Montage images of 4 radial OCT scans (horizontal, vertical, and 2 oblique scans) through the fovea were obtained in each case. MAIN OUTCOME MEASURES:Montage SD OCT images. RESULTS:In fellow eyes, potential precursor changes to macular hole revealed shallow perifoveal vitreous separation that extends peripherally toward the equator. Two distinct configurations were noted at the posterior vitreous face; eyes without holes had a smooth curvature, whereas eyes with holes were more likely to have wavy, folded, or scalloped vitreous surfaces. At the onset of separation, most posterior vitreous cortex had a smooth curvature, but posterior vitreous folds increased with progressive separation. Also notable were zones of double-layered retinoschisis in regions of adherent posterior vitreous. Resulting granular hyperreflection in the peripheral vitreous was detectable in 50% to 60% of stage 1 or 2 holes but in only 33% of stage 3 or 4 holes. CONCLUSIONS:The SD OCT montages taken at serial stages of idiopathic macular holes document distinct configurations of the posterior vitreous face, granular hyperreflection in the peripheral vitreous, and areas of peripheral retinoschisis. Montaging SD OCT images provides novel cross-sectional images of the vitreoretinal interface that may have broader application. FINANCIAL DISCLOSURE(S):The author(s) have no proprietary or commercial interest in any materials discussed in this article.
journal_name
Ophthalmologyjournal_title
Ophthalmologyauthors
Mori K,Kanno J,Gehlbach PL,Yoneya Sdoi
10.1016/j.ophtha.2012.06.027subject
Has Abstractpub_date
2012-12-01 00:00:00pages
2600-8issue
12eissn
0161-6420issn
1549-4713pii
S0161-6420(12)00558-1journal_volume
119pub_type
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