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P. Gupta, B. J. Lujan, G. Gregori, H. W. Flynn, W. E. Smiddy, C. A. Puliafito; 3-Dimensional Visualization of the Hyaloid Face in Idiopathic Macular Hole by Spectral-Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4249. doi: https://doi.org/.
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While the exact pathogenesis of idiopathic macular holes remainsunclear, the interaction of the posterior hyaloid face withthe retina as seen by optical coherence tomography (OCT) suggeststhe vitreous is an active component. Spectral-domain OCT (SD-OCT)provides high resolution, volumetric data in which the vitreo-retinalinterface of patients with macular holes can be modeled threedimensionally.
4 eyes with full-thickness idiopathic macular holes were scannedusing SD-OCT. A 6mm x 6mm area was acquired using a raster scanprotocol consisting of 512x128 axial scans. The posterior hyaloidface was manually demarcated on each of the 128 slices and wasthen rendered as a three-dimensional model above the plane ofthe internal limiting membrane (ILM).
Three-dimensional images were successfully generated in eachof the eyes, showing the interface between the hyaloid and theILM. Each of these models showed the hyaloid face to be touchingthe ILM adjacent to the fovea, with surrounding separation ofthe vitreous and retina. Three-dimensional ripples were visualizedon the hyaloid that were not uniform in all directions, thussuggesting differing tensions along the vitreo-retinal interface.
SD-OCT can evaluate the interaction between the retina and theposterior hyaloid three-dimensionally. Visualization and futurequantitation of this anatomy may provide a greater understandingof the role that the vitreous plays in macular hole formationand progression.
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