Three-dimensional observations of developing macular holes
Autor: | Shohi Kishi, Hideto Takahashi |
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Rok vydání: | 2000 |
Předmět: |
Male
Light genetic structures Diagnostic Techniques Ophthalmological Vitreous Detachment Retina Ophthalmoscopy Optical coherence tomography medicine Humans Prospective Studies Tomography Macular hole Aged medicine.diagnostic_test business.industry Retinal Detachment Retinal detachment Anatomy Middle Aged Retinal Perforations medicine.disease eye diseases Scanning laser ophthalmoscopy Ophthalmology Interferometry medicine.anatomical_structure Vitreous membrane Maculopathy Female sense organs business |
Zdroj: | American Journal of Ophthalmology. 130:65-75 |
ISSN: | 0002-9394 |
Popis: | PURPOSE: To describe the morphologic features of idiopathic macular holes and vitreous traction during macular hole evolution. METHODS: We prospectively examined 89 eyes of 82 patients with idiopathic macular holes (stage 1, 15 eyes; stage 2, 16 eyes; stage 3, 50 eyes; stage 4, eight eyes) using optical coherence tomography. In addition to optical coherence tomography, scanning laser ophthalmoscopy was performed in all 15 eyes with stage 1 hole, six of 16 eyes with stage 2, and 19 of 50 eyes with stage 3. RESULTS: In stage 1 eyes, optical coherence tomography revealed retinal split or cystic changes at the fovea in 11 of 15 eyes (73%) and foveal retinal detachment in four eyes (27%). Two eyes with foveal cysts progressed to stage 2, and one developed a stage 3 hole. In one eye with retinal detachment, the detached retina thinned and developed dehiscence. Optical coherence tomography showed a vitreous cortex that was detached in the perifoveal area but attached on the fovea in 11 of the 15 stage 1 eyes. In stage 2 macular holes, retinal tissue extending from the perifoveal retina formed a flap. Scanning laser ophthalmoscopy demonstrated intraretinal radiating striae, which corresponded to a foveal cyst or perifoveal cystic changes. CONCLUSIONS: Macular holes start as retinal splits or foveal cysts in most cases. The anterior wall of the cyst serves as a flap in stage 2 and an operculum in stage 3 holes. Radiating striae correspond to retinal splits or cysts and presumably represent an elevation of Henle fiber. In a few macular holes, foveal detachment is the initial change. The detached retina thins and eventually develops a hole. In both courses, anterior traction of the slightly detached vitreous cortex appears to be a major contributing factor to macular hole formation. |
Databáze: | OpenAIRE |
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