title: Full-Thickness Macular Hole Formation after Internal Limiting Membrane Peeling: Beware the "Omega Sign".
abstract: Purpose. To introduce a clinical sign on spectral domain optical coherence tomography (SDOCT), which may indicate high risk for full-thickness macular hole formation after internal limiting membrane (ILM) peeling.Methods. The preoperative SDOCT images of two patients-one with multilaminar hemorrhage from ruptured retinal artery macroaneurysm and one with serous retinal detachment and severe macular schisis from optic pit maculopathy-who developed full-thickness macular hole (FTMH) after ILM peeling were evaluated retrospectively.Results. On the preoperative SDOCT images of both patients there was a thin bridge of tissue on either side of the foveal center with an outer retinal defect. The photoreceptors were displaced laterally away from the foveal center to create an "omega-" shaped configuration of the remaining tissue.Conclusion. "Omega-" shaped configuration on SDOCT may represent a higher risk of FTMH following ILM peeling. Vitreoretinal surgeons may wish to consider this sign in the process of their surgical decision making.
authors.affiliation: Cincinnati Eye Institute, Cincinnati, OH, USA; Department of Ophthalmology, University of Cincinnati School of Medicine, Cincinnati, OH, USA.
authors.forename: Robert A
authors.identifier: 0000-0003-0328-7927
authors.initials: RA
authors.lastname: Sisk
authors.affiliation: Cincinnati Eye Institute, Cincinnati, OH, USA; Department of Ophthalmology, Bahcesehir University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Okan
authors.identifier: 0000-0002-1072-3574
authors.initials: O
authors.lastname: Toygar