Stage 3 macular hole: role of optical coherence tomography and of B-scan ultrasonography.
OBJECTIVE
To analyze the various aspects of Stage 3 macular hole with optical coherence tomography (OCT) and B-scan ultrasonography.


METHODS
Observational case series.


METHODS
Patients referred for full-thickness macular hole were prospectively screened with OCT and B-scan ultrasonography. OCT examination analyzed the diameter of the hole, the posterior hyaloid, the surrounding retina, and the inconstant presence of a pseudo-operculum. B-scan ultrasonography permitted the distinction between stage 3 and stage 4 holes, based on the detachment of the posterior hyaloid.


RESULTS
The study included 62 eyes with stage 3 holes. On OCT, the typical aspect with a hyaloid detached from the macular area was observed in 37% of the eyes (group 3C). In 42% of the eyes (group 3B), a focal adherence was visible at the margin of the hole, as in stage 2 macular hole, but the hole was long-standing, large, and noneccentric. In 21% of the eyes, the hyaloid was not visible anterior to the retina but was still adherent to it (group 3A). In the absence of B-scan ultrasonography, these OCT features could be confused with a stage 4 macular hole. No difference in the size of the hole was observed between subgroups.


CONCLUSIONS
OCT can show various aspects of stage 3 macular holes. B-scan ultrasonography was useful for assessing the location of the posterior hyaloid and to distinguish stage 3 from stage 4 macular holes. These features may provide additional information on the pathogenesis of macular hole and may have therapeutic implications.
Glacet-Bernard
Agnès
A
Service d'Ophthalmologie, University Eye Clinic of Créteil, Intercommunal and Henri Mondor (Assistance Publique des Hôpitaux de Paris) Hospitals, University of Paris XII, 40 avenue de Verdun, 94010 Créteil, France. agnes.glacet@chicreteil.fr
Zourdani
Alain
A
Perrenoud
François
F
Coscas
Gabriel
G
Soubrane
Gisèle
G
D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012167:Retinal Perforations / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014822:Vitreous Body / Q000000981:diagnostic imaging