Optical coherence tomography of the vitreoretinal interface in macular hole formation

Aims-To image the vitreoretinal interface and provide further information o n the pathogenesis of idiopathic macular hole formation. Methods-Prospective recruitment of 80 eyes of 41 consecutive patients refer red with a diagnosis of idiopathic full thickness macular hole (FTMH) to a teaching hospital retinal clinic. Both eyes of each patient underwent optic al coherence tomography (OCT) imaging with vertical and horizontal scans ce ntred on the fovea. Results-A total of 30 eyes had stage 2 or 3 FTMHs and, of these, 21 had per sistent vitreofoveal attachment and associated prefoveal opacities. IS pref oveal opacities were identified by Goldmann contact lens examination and co nfirmed on OCT examination. Three prefoveal opacities were identified only on OCT examination. 10 eyes had stage 4 FTMHs and four cases were identifie d in whom the OCT appearance was consistent with impending, aborted, or lam ellar macular holes. Conclusions-The wide range in OCT appearance of macular holes and associate d prefoveal opacities suggests that, in at least some cases, a significant amount of retinal tissue is torn from the foveal area during macular hole f ormation. OCT imaging provides additional information on macular hole patho genesis and is valuable in the planning of surgical intervention.