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O. S. Punjabi, H. W. Flynn, Jr., J. E. Legarreta, G. Lalwani, G. Gregori, R. W. Knighton, W. E. Smiddy, P. J. Rosenfeld, C. A. Puliafito; Spectral Domain Optical Coherence Tomography of Idiopathic Macular Holes and Their Vitreoretinal Relationships. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5661.
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© ARVO (1962-2015); The Authors (2016-present)
To document the appearance and vitreoretinal relationship of idiopathic macular holes using two prototype (high resolution and ultra-high resolution) Spectral domain Optical Coherence Tomography (SDOCT) systems.
SDOCT allows the acquisition of raster scans covering large regions of the retina in relatively short time periods due to its higher speed (approximately 26000 A-scans/s) compared to time domain OCT systems (400 A-scans/s). An observational case-series study was performed in thirty two patients diagnosed with idiopathic macular hole and scanned using a prototype 8 µm axial resolution SDOCT. In addition, a prototype ultra-high resolution SDOCT (4 µm axial resolution) system was used in some of these patients. The diagnosis of macular hole was based on posterior segment examination (PSE), color fundus photography and StratusOCTTM. Some of these patients were scanned after spontaneous closure or following macular hole surgery.
SDOCT could accurately demonstrate the morphology and vitreoretinal relationship of macular holes in these patients. The hyloid face, depth of the hole and integrity of the photoreceptor layer could be better visualized with the SDOCT than the StratusOCTTM in most patients, because of higher density of images and better resolution. StratusOCTTM radial line B-scans allowed visualization of only certain regions of the retina, and hence the presence or absence of posterior vitreous detachment (PVD) could not be ascertained in 12 patients. SDOCT could accurately demonstrate attachment or detachment of the posterior hyloid face in these patients, which was important for surgical decisions. In addition, reconstructed fundus images obtained from these B-scans allowed accurate image registration. Three-dimensional visualization of these holes was possible following segmentation of the internal limiting membrane (ILM) and retinal pigment epithelium (RPE). Spontaneous closure occurred in 2 patients, and closure following surgery was documented in 5 patients.
SDOCT provided additional information about morphology and vitreoretinal relationship of idiopathic macular holes, which may be clinically useful.
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