A study of macular hole formation by serial spectral optical coherence tomography

  1. Zofia Michalewska MD1,*,
  2. Janusz Michalewski MD1,
  3. Bartosz L Sikorski MD2,
  4. Jakub J Kałużny MD, PhD2,
  5. Maciej Wojtkowski PhD3,
  6. Ron A Adelman MD, MPH4,
  7. Jerzy Nawrocki MD, PhD1

Article first published online: 6 APR 2009

DOI: 10.1111/j.1442-9071.2009.02041.x

Issue

Clinical & Experimental Ophthalmology

Clinical & Experimental Ophthalmology

Volume 37, Issue 4, pages 373–383, May/June 2009

Additional Information

How to Cite

Michalewska, Z., Michalewski, J., Sikorski, B. L., Kałużny, J. J., Wojtkowski, M., Adelman, R. A. and Nawrocki, J. (2009), A study of macular hole formation by serial spectral optical coherence tomography. Clinical & Experimental Ophthalmology, 37: 373–383. doi: 10.1111/j.1442-9071.2009.02041.x

Author Information

  1. 1

    ‘Jasne Blonia’ Eye Clinic, Lodz,

  2. 2

    Department of Ophthalmology, and Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz,

  3. 3

    Department of Biophysics and Medical Physics, Nicolaus Copernicus University, Torun, Poland; and

  4. 4

    Yale University Eye Center, Retina Service, New Haven, USA

*Dr Zofia Michalewska, ‘Jasne Blonia’ Eye Clinic, ul. Rojna 90, 91-162 Lodz, Poland. Email: zosia_n@yahoo.com

Publication History

  1. Issue published online: 30 JUN 2009
  2. Article first published online: 6 APR 2009
  3. Received 18 August 2008; accepted 12 March 2009.

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Keywords:

  • macular hole;
  • spectral optical coherence tomography;
  • ultrahigh-resolution optical coherence tomography

Abstract

Background:  The purpose of this paper is to evaluate changes of the vitreoretinal interface in fellow eyes of eyes with a macular hole and to study early stages of macular hole formation by spectral optical coherence tomography (SOCT).

Methods:  A prospective study of 131 consecutive patients with history of macular hole. Serial SOCT examinations were performed on the fellow eyes four times during a 6-month observation period. Progression of foveal changes and formation of macular hole in the fellow eyes were studied.

Results:  Seven distinct abnormalities in the foveal region were noted in 70 of the fellow eyes (53.4%). Additionally in 18 patients (13.6%) other defects typical for the older population were noted. Gradual evolution to full-thickness macular holes during the 6-month observation period was noted in five eyes. One of these eyes had a previously detected cyst, and four eyes had elevation of the photoreceptor layer.

Conclusions:  The high prevalence of macular abnormalities in the fellow eyes particularly epiretinal membranes and vitreous traction with schizis as well as the evolution of these abnormalities over time suggest that diseases of the vitreomacular interface may have similar pathogenesis. Macular hole formation often starts as a triangular elevation of the photoreceptor layer. In some cases, a cyst in the inner retinal layers can be an early step in macular hole formation.

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