Watzke-Allen slit beam test in macular holes confirmed by optical coherence tomography.
OBJECTIVE
To examine the role, validity, and interpretation of Watzke-Allen slit beam testing in patients with idiopathic senile macular holes.


METHODS
Thirty-seven consecutive patients with 40 full-thickness macular holes, confirmed on optical coherence tomography, were prospectively recruited. The Watzke-Allen slit beam test was used centrally and on the rim of the macular hole in both vertical and horizontal orientations.


RESULTS
In 24 eyes, the beam was reported as thinned in both vertical and horizontal orientations when placed directly over the center of the macular hole. In 9 eyes, the Watzke-Allen slit was reported as broken in both vertical and horizontal orientations. In 6 eyes, the beam was reported as broken in one orientation and thinned in the other. In 1 eye, the beam was reported as kinked but not thinned or broken. When the beam was placed on the edge of the macular hole, all patients reported a displacement or bowing of the beam away from the center of the hole.


CONCLUSIONS
These findings confirm tangential traction of photoreceptors from a central foveal dehiscence as the causative mechanism in the development of the majority of macular holes. Careful interpretation of the Watzke-Allen sign may offer a technique for preoperatively determining visual prognosis. Arch Ophthalmol. 2000;118:1059-1063
Vitreo-retinal Unit, Department of Ophthalmology, 9th Floor, North Wing, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, England. TANNERONE@aol.com.
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D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D007368:Interferometry; D008027:Light; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012167:Retinal Perforations / Q000175:diagnosis*; D014054:Tomography / Q000379:methods; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity