Morphological evaluation of full-thickness idiopathic macular holes by optical coherence tomography

Purpose. To assess the efficacy of optical coherence tomography (OCT) for t he morphological evaluation of idiopathic full-thickness macular holes and for detecting any morphological changes with time. Methods. Serial sagittal tomographs through the macula were taken by OCT in a consecutive series of 34 eyes of 34 patients with diagnosis of idiopathi c full-thickness macular hole. The patients were divided into two groups on the basis of "recent" (group 1, 25 patients) or "not-recent" (group 2, 9 p atients) onset of symptoms related to the macular hole. Fourteen of the 25 patients in group 1 and all nine in group 2 underwent vitrectomy. The 11 in group 1 who refused surgery were observed by OCT examination with follow-u p from 6 to 13 months. Results. In most eyes OCT scans revealed two different anatomical features of macular holes depending on the time of onset of symptoms. Eleven of the 14 "recent-onset" holes that underwent surgery showed "sharp", undermining edges at preoperative OCT; the other three had "rounded" edges. Seven of th e nine eyes operated for long-standing full-thickness macular holes had pre operative "rounded" edges, while the edges in the remaining two eyes were " sharp". OCT of eight of the 11 non-operated eyes in group 1 showed a morpho logical evolution of the macular hole edges from a "sharp" to a "rounded" c ontour and an increase in the diameter of the hole. Conclusions. OCT can help in the morphological evaluation of idiopathic ful l-thickness macular holes and in the detection of morphological changes wit h time.