Montage images of spectral-domain optical coherence tomography in eyes with idiopathic macular holes.
OBJECTIVE
To describe the morphologic and anatomic relationships at the vitreoretinal interface, from the macula into the periphery, in patients with idiopathic macular hole. Montaged images of posterior and peripheral spectral-domain (SD) optical coherence tomography (OCT) studies were used to describe the anatomic vitreoretinal relationships.


METHODS
Prospective, consecutive, observational case series.


METHODS
Forty-six eyes of thirty-six consecutive patients with idiopathic macular hole and their fellow eyes.


METHODS
Montage images of 4 radial OCT scans (horizontal, vertical, and 2 oblique scans) through the fovea were obtained in each case.


METHODS
Montage SD OCT images.


RESULTS
In fellow eyes, potential precursor changes to macular hole revealed shallow perifoveal vitreous separation that extends peripherally toward the equator. Two distinct configurations were noted at the posterior vitreous face; eyes without holes had a smooth curvature, whereas eyes with holes were more likely to have wavy, folded, or scalloped vitreous surfaces. At the onset of separation, most posterior vitreous cortex had a smooth curvature, but posterior vitreous folds increased with progressive separation. Also notable were zones of double-layered retinoschisis in regions of adherent posterior vitreous. Resulting granular hyperreflection in the peripheral vitreous was detectable in 50% to 60% of stage 1 or 2 holes but in only 33% of stage 3 or 4 holes.


CONCLUSIONS
The SD OCT montages taken at serial stages of idiopathic macular holes document distinct configurations of the posterior vitreous face, granular hyperreflection in the peripheral vitreous, and areas of peripheral retinoschisis. Montaging SD OCT images provides novel cross-sectional images of the vitreoretinal interface that may have broader application.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan. keisuke@saitama-med.ac.jp
Keisuke
K
Mori
Junji
J
Kanno
Peter L
PL
Gehlbach
Shin
S
Yoneya
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D010781:Photography; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D012167:Retinal Perforations / Q000175:diagnosis*; D041441:Retinoschisis / Q000175:diagnosis; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology*