Abstract
Abstract: :
Purpose: To assess the usefulness of Optical Coherence Tomography (OCT) in distinguishing lamellar macular holes from pseudoholes caused by contraction of an epiretinal membrane(ERM) . Methods: 71eyes of 70 patients (39 females and 31 males) exhibiting a false macular hole appearance on biomicroscopy, were examined by OCT. Patients mean age was 67 years (range 17 to 85 ). Three and 6 mm long scans were recorded through the center of the fovea in at least the vertical and horizontal directions. Results: In 41 cases the OCT image showed a steepened foveal pit contour combined with thickening of the foveal edges. At the center of the pseudohole, macular thickness was normal or increased with a mean thickness of 165µm (range 114-295 µm, normal 146 20 µm). Mean VA was 0.5. The macular profile of this group fits well with the probability of centripetal contraction of an epiretinal membrane, present in all cases on biomicroscopy.In the 30 other cases, the macular profile was different.The central retina was thinner than normal and fairly irregular (mean central thickness: 72 µm (range 34-112µm).The edges of the macula were split laterally by an intraretinal cleft . Mean VA was 0.5.This feature was consistent with the diagnosis of macular lamellar hole, a condition due to the opening of a macular cyst. In 7 of the 30 cases, an operculum was present in the plane of the partially detached posterior hyaloid, and was visible in front of the lamellar hole. An ERM was also present around the lamellar hole in 19/30 cases. Conclusion: OCT is useful for differentiating pseudoholes due to ERM contraction from lamellar holes due to partial opening of a macular cyst , two conditions between which it can be difficult to differentiate on biomicroscopy, as an ERM may be present in both cases.
Keywords: 554 retina • 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)