Morphological evaluation of full-thickness idiopathic macular holes by optical coherence tomography.
OBJECTIVE
To assess the efficacy of optical coherence tomography (OCT) for the morphological evaluation of idiopathic full-thickness macular holes and for detecting any morphological changes with time.


METHODS
Serial sagittal tomographs through the macula were taken by OCT in a consecutive series of 34 eyes of 34 patients with diagnosis of idiopathic full-thickness macular hole. The patients were divided into two groups on the basis of "recent" (group 1, 25 patients) or "not-recent" (group 2, 9 patients) onset of symptoms related to the macular hole. Fourteen of the 25 patients in group 1 and all nine in group 2 underwent vitrectomy. The 11 in group 1 who refused surgery were observed by OCT examination with follow-up from 6 to 13 months.


RESULTS
In most eyes OCT scans revealed two different anatomical features of macular holes depending on the time of onset of symptoms. Eleven of the 14 "recent-onset" holes that underwent surgery showed "sharp", undermining edges at preoperative OCT; the other three had "rounded" edges. Seven of the nine eyes operated for long-standing full-thickness macular holes had preoperative "rounded" edges, while the edges in the remaining two eyes were "sharp". OCT of eight of the 11 non-operated eyes in group 1 showed a morphological evolution of the macular hole edges from a "sharp" to a "rounded" contour and an increase in the diameter of the hole.


CONCLUSIONS
OCT can help in the morphological evaluation of idiopathic full-thickness macular holes and in the detection of morphological changes with time.
Ripandelli
G
G
G.B. Bietti Foundation for Ophthalmology, Roma, Italy. Eyefoundbietti@eyefoundbietti.it
Coppé
A M
AM
Bonini
S
S
Giannini
R
R
Curci
S
S
Costi
E
E
Stirpe
M
M
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000473:pathology*; D013997:Time Factors; D014054:Tomography / Q000379:methods*; D014821:Vitrectomy