[Imaging of vitreoretinal adhesions in the partner eye of patients with penetrating macular foramina in optical coherence tomography].
BACKGROUND
Vitreoretinal adhesions play a crucial role in the development of a macular hole. To visualize vitreoretinal adhesion we used optical coherence tomography to investigate fellow eyes of patients with macular holes.


METHODS
In a prospective study we scanned the retina in 188 patients with a macular hole stage III or IV (Gass classification). The foveal shape and vitreous were classified into grades.


RESULTS
Of the 188 patients 45% showed no vitreous reflex, 45% a partial vitreous detachment with foveolar adhesions, and 10% a vitreous detachment with complete separation from the fovea. While eyes with normal foveolar shape displayed partial vitreous detachment in 33%, this figure rose to 66% in eyes with a macular hole stage I.


CONCLUSIONS
Diffuse thickening of the fovea is followed by an intraretinal split and formation of a cyst. The shape of the foveolar adhesion suggests that continuing anteroposterior vitreal traction leads to a retinal break and formation of a full-thickness macular hole.
Augenklinik, Ludwig-Maximilians Universität München, Klinikum Innenstadt, Mathildenstrasse 8, 80336 München. Martin.Thiel@ak-i.med.uni-muenchen.de
M J
MJ
Thiel
M
M
Bechmann
S
S
Ullrich
C
C
Gass
C
C
Haritoglou
C
C
Binder
N
N
Kristin
C A
CA
Lackerbauer
A
A
Gandorfer
M W
MW
Ulbig
D000368:Aged; D005260:Female; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012167:Retinal Perforations / Q000175:diagnosis*; D000267:Tissue Adhesions; D014054:Tomography; D014822:Vitreous Body / Q000473:pathology*; D020255:Vitreous Detachment / Q000175:diagnosis