Abstract
Purpose: :
A case of newly diagnosed and subsequent non-treatment (seven months) of VMT with full thickness macular hole is studied using optical coherence tomography (OCT).
Methods: :
A total of eight separate patient examinations were completed over a seven month period (September 2006-March 2007). Despite evidence of a full-thickness macular hole, the patient declined surgical treatment for the initial seven month period. Standard vitreo-retinal examinations with OCT scans were completed at each visit.
Results: :
On the initial visit, OCT revealed a combination of central VMT, full-thickness macular hole and associated cystoid macular edema. Evidence of VMT was present on all six central OCT meridians while macular hole was only visible on 1/6. The BCVA on presentation was 20/100. Vitreo-macular traction with full thickness macular hole remained present on all follow-up examinations (n=7). Evidence of full-thickness macular hole was only present on 1/6 meridians in all except the last two visits. On visits 2-6 the BCVA range was 20/50 to 20/63, with the size of macular hole unchanged. On visits 7 and 8, BCVA was 20/100 and 20/200 respectively, with a significant increase in central retinal thickness and macular hole size.
Conclusions: :
As evident in the study case, it is imperative to review all radial scans included in the macular analysis OCT protocol, as full-thickness macular hole can be present on only 1/6 of the standard six meridian scans. Visual acuity, VMT, macular hole size, and retinal thickness may remain stable over many months in untreated cases.
Keywords: macular holes • macula/fovea • edema