DIFFERENTIATING FULL-THICKNESS MACULAR HOLES FROM IMPENDING MACULAR HOLES AND MACULAR PSEUDOHOLES

Aims--The reliability of scanning laser ophthalmoscope (SLO) microperi metry in differentiating full thickness macular holes from macular pse udoholes and impending macular holes was evaluated. Methods--106 eyes with the clinical diagnosis of full thickness macular holes, macular p seudoholes, and impending (stage 1) macular holes were examined for th e presence of deep or relative scotoma using SLO microperimetry. The r elation between these scotomas and the clinical diagnosis was studied. Results--Deep and relative scotomas were detected in all 57 eyes with clinically defined full thickness macular holes. In contrast, among 4 9 eyes diagnosed with macular pseudoholes or impending macular holes, no deep and only one relative scotoma was observed. The sensitivity of the presence of a deep scotoma as an indicator of the clinical diagno sis of a full thickness macular hole was 100% (57 of 57), and the spec ificity was 100% (49 of 49). The sensitivity of the presence of a rela tive scotoma was 100% (57 of 57) and the specificity was 98.0% (48 of 49). Conclusion--With SLO microperimetry, full thickness macular holes can be precisely and objectively distinguished from other conditions that mimic macular holes.