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S. M. Pfahler, V. Djafari; Chronological Progression of Combination Vitreomacular Traction and Full-Thickness Macular Hole Over a Six Month Period Documented by Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3222. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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).
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.
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.
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.
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