Optical Coherence Tomography Characteristics of Full-Thickness Traumatic Macular Hole

Abstract

Purpose:: To describe the optical coherence tomography (OCT) characteristics of patients with full-thickness traumatic macular hole (TMH) and to correlate them with biomicroscopy and fluorescein angiography (FA) findings.

Methods:: Observational retrospective multicenter study at 6 centers from 5 countries. Twelve eyes of 10 consecutive patients with full-thickness TMH participated in this study. Patients underwent biomicroscopic fundus examination, color fundus photography and OCT. Main outcome measures included OCT characteristics, and correlation with biomicroscopy and FA.

Results:: Traumatic macular hole was documented with OCT in five woman and five men. Mean (range) Time between trauma and MH diagnosis was 8.1 (between 1- to 24) months (mean: 8.1 months). The shape of TMHs was round in 11 (91.7%) eyes. The posterior vitreous was completely detached in 6 (50%) eyes, and with an operculum in one (8.3%) eye. The most common findings seen on OCT were: 1) Full-thickness loss of retinal tissue through the hole with sharp edges perpendicular to the retinal pigment epithelium in 5 (41.7%) eyes; 2) TMH with an operculum totally detached from the hole’s edge in 2 (16.7%) eyes; 3) Presence of epiretinal membrane around of hole in three (25%) eyes; and 4) Presence of abnormalities of the surrounding retina in all (100%) eyes including: a) Nonreflective spaces within the neurosensory retina surrounding the hole (cysts) 6 (50%) eyes, b) Region of slightly reduced optical reflectivity and increased retinal thickness evident in the region surrounding the hole (intraretinal edema) in 6 (50%) eyes, c) Minimally reflective space within or beneath the neurosensory retina in the fovea (subretinal cuff of fluid) in 9 (75%) eyes. Our characteristics correlated well with biomicroscopic findings. However, the characteristics of the surrounding retina that were evident on OCT were not seen clearly with FA, and these characteristics may be predictive for final visual acuity (VA) in TMHs. Only one of the TMH closed spontaneously in our series.

Conclusions:: Optical coherence tomography complements biomicroscopy, and FA in the evaluation of full-thickness TMHs. Optical coherence tomography findings and abnormalities of the surrounding retina may be important predictors of VA after surgery.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina • imaging/image analysis: clinical