Fundus autofluorescence in macular hole surgery.
BACKGROUND
Macular holes usually are diagnosed by biomicroscopy. Fluorescence angiography (FLA) is helpful especially for judging early stages or pseudoforamina. The importance of fundus-autofluorescence in macular hole surgery was studied.


METHODS
Twenty-five consecutive patients with macular holes (n = 21) and clinically-similar appearances (n = 4) were examined biomicroscopically. In addition, fundus-autofluorescence and FLA were determined by Heidelberg-Retina-Angiograph (HRA, Heidelberg, Germany). A vitrectomy was performed on 16 patients with macular hole stage II, III, and IV, and membrane peeling was performed if necessary. Platelet-concentrate as an adjuvant agent was used in all surgeries, and all 16 patients were examined afterward.


RESULTS
In all patients with macular hole stage III and IV (n = 18), fundus-autofluorescence revealed a marked hyperfluorescent spot in the foveolar region and also a hyperfluorescence in FLA. Patients with macular hole stage II (n = 3) showed a slight punctured hyperautofluorescence and a subtle window-defect in the FLA. Postoperatively, the autofluorescence was normal in all eyes with a closed macular hole (87.5%). In some patients, a variable punctured hyperautofluorescence was noticed (n = 3). In eyes with pseudoforamina, the autofluorescence was normal (n = 4).


CONCLUSIONS
In macular hole diagnostics, fun-dus-autofluorescence is able to replace invasive fluorescence angiography. The autofluorescence is helpful for the examination of pseudoforamina and might be useful for estimating therapeutic success.
Framme
C
C
University Eye Clinic, Regensburg, Germany.
Roider
J
J
D000368:Aged; D005260:Female; D005451:Fluorescein Angiography; D005453:Fluorescence; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy