Purpose:
Montaged images of posterior and peripheral spectral domain-optical coherence tomography (SD-OCT) studies were used to describe the dynamic, anatomical vitreoretinal relationships.
Methods:
Forty six eyes of thirty six consecutive patients with idiopathic macular hole and their fellow eyes. Montage images of 4 radial OCT scans (horizontal, vertical and two oblique scans) through the fovea were obtained in each case.
Results:
In fellow eyes, potential precursor changes to macular hole reveal shallow perifoveal vitreous separation that extends peripherally towards 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 onset of separation most posterior vitreous cortex had a smooth curvature but posterior vitreous folds increased with progressive separation. Also notable were double-layered retinoschises in regions of adherent posterior vitreous. Resulting granular hyperreflection in the peripheral vitreous was detectable in 50-60% of stage 1-2 holes but only 33% of stage 3-4 holes.
Conclusions:
SD-OCT montages taken during the development of idiopathic macular holes document distinct configurations of the posterior vitreous face, granular hyperreflection in the peripheral vitreous and areas of peripheral retinoschises. Montaging SD-OCT images provides novel cross-sectional images of the vitreoretinal interface that may have broader application.
Keywords: macular holes • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)