title: Idiopathic full-thickness macular holes and the vitreomacular interface: a high-resolution spectral-domain optical coherence tomography study.
abstract: OBJECTIVE
  To analyze the vitreomacular interface in idiopathic full-thickness macular holes (MHs) using spectral-domain optical coherence tomography.
  
  
  METHODS
  Prospective cross-sectional case series.
  
  
  METHODS
  Ninety-one eyes of 86 consecutive patients with a MH were examined by spectral-domain optical coherence tomography. The vitreomacular interface was assessed and the presence or absence of an operculum was analyzed.
  
  
  RESULTS
  Fifty-two eyes had a stage 2 MH, 12 eyes a stage 3 MH, and 27 eyes a stage 4 MH. No posterior hyaloid membrane was detected in any eyes with a stage 4 MH. In 35 (54.7%) of the 64 eyes with an MH without a complete posterior vitreous detachment (PVD), we saw a perifoveal PVD with vitreofoveal adhesion and partial dehiscence of the raised inner retina with an outer retinal separation in the MHs. In 24 (37.5%) of the 64 eyes without a complete PVD, an operculum, which is a hyperreflective structure of the foveal retina, was in front of the MH. The posterior hyaloid membrane was separated completely but adhered to the optic disc. In 2 (3.1%) of the 64 eyes without a complete PVD, the posterior hyaloid membrane was separated from the macula without an operculum. In 3 (4.7%) of the 64 eyes without a complete PVD, vitreofoveal adhesion on both edges of the hole was connected to the taut posterior hyaloid membrane without an operculum.
  
  
  CONCLUSIONS
  The vitreomacular interface had 4 configurations in MHs without a complete PVD. Approximately 55% of cases with an open roof in the eyes without a complete PVD may be at risk for progression to operculum formation (loss of retinal tissue).
authors.affiliation: Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Taiji
authors.initials: T
authors.lastname: Nagaoka
authors.forename: Akira
authors.initials: A
authors.lastname: Takamiya
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kagokawa
authors.forename: Daiki
authors.initials: D
authors.lastname: Kameyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Sogawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishiko
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirokawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D012167:Retinal Perforations / Q000175:diagnosis*; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology*; D020255:Vitreous Detachment / Q000175:diagnosis