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C.W. Vaughn, T.M. Johnson, B.M. Glaser; Assessment of Macular Features Differentiating Macular Pseudohole From Idiopathic Epiretinal Membrane Using Optical Coherence Tomography . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1575.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the prevalence of macular pseudohole in a population of idiopathic epiretinal membranes (ERM) and characterize features that differentiate pseudoholes from epiretinal membranes on optical coherence tomography(OCT). Methods: In a retrospective case–control study, patients were selected from a database of patients with epiretinal membranes. Only patients with idiopathic ERM were included, all other vitreoretinal pathology was excluded. Cases were defined as subjects clinically diagnosed with an ERM associated with a central pseudohole. Controls were defined as subjects with evidence of idiopathic ERM without pseudoholes. All patients were examined with OCT–3 (Version 3.0, Carl Zeiss Meditec, Inc. Dublin, CA)on initial presentation. Both the presence of epiretinal membrane and macular pseudohole were determined by OCT–3 and clinical biomicroscopy. OCT studies were examined for several features including a break in the ERM, the presence of a right–angled fovea and retinal thickness. A break in the ERM was defined as an interruption in the continuity of the membrane as it crossed the retinal surface. The presence of a right–angle in the foveal contour was also assessed. The nasal, temporal, superior, inferior, and central retinal thickness was measured 750 microns from the foveal center using the caliper function included in the OCT–3 software. A preliminary analysis using paired t–tests was performed. Results: 29 eyes in 23 patients served as cases in our study compared to 53 eyes in 42 patients for controls. The prevalence of macular pseudohole in our patient population of idiopathic epiretinal membrane was 35.4%. ETDRS visual acuity at presentation measured in LogMar format revealed a mean of 0.28 for case group vs. 0.30 for controls (p–value: 0.827). Breaks in epiretinal membranes was significantly more frequent in the pseudohole group (83% vs. 43%, p–value< 0.0001). The presence of a right–angled foveal contour was significantly more common in the pseudohole patients (72% vs. 6% p–value< 0.0001). Mean central retinal thickness was significantly less in the pseudohole patients (212 microns vs. 303 microns, p–value: 0.0058). Differences between nasal, temporal, superior, and inferior retinal thickness were not statistically significant between groups. Conclusions: Macular pseudohole occurs commonly in the setting of idiopathic epiretinal membrane. Several features on OCT examination differentiate pseudoholes from ERM including a break in the ERM, the presence of a right–angled fovea and the presence of normal central retinal thickness.
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