Background: Anatomic characteristics of macular holes may be difficult
to define, even with contact lens biomicroscopy. With the advent of s
uccessful macular hole surgical techniques, accurate diagnosis has bec
ome increasingly important to avoid unnecessary or incorrect surgery.
Echography may provide additional diagnostic information in some cases
. The purpose of this study is to correlate echographic and intraopera
tive clinical features of macular holes. Methods: The echographic feat
ures and intraoperative findings in 25 patients were compared. The spe
ctrum of identifiable echographic features included (1) a thin, smooth
, membrane-like surface minimally elevated over the macula (limited po
sterior vitreous face separation); (2) macular thickening; (3) an oper
culum; and (4) a complete posterior vitreous face separation. Intraope
rative clinical findings included the presence or absence of (1) a thi
n, limited posterior vitreous face separation, (2) a subretinal fluid
cuff, (3) an operculum, and (4) a complete posterior vitreous face sep
aration. Results: Echographic and intraoperative findings correlated r
egarding the limited posterior face separation in 23 of 25 patients, a
surrounding subretinal fluid cuff (macular thickening) in 24 of 25 pa
tients, an operculum in 19 of 25 patients, and complete posterior vitr
eous face separation in 24 of 25 patients. Thus, echography was very e
ffective in detecting the position of the posterior vitreous face. Ove
rall, echography correlated accurately with 90 (90%) of 100 of these t
our features. Conclusion: Echographic features correlate accurately wi
th clinical features.