Preoperative scanning laser ophthalmoscope: findings in idiopathic macularforamen

Background. The aim of our study was a detailed morphological and functiona l assessment of macular foramen stages II-IV by scanning laser ophthalmosco py (SLO) and fundus perimetry including a correlation with clinical finding s. Methods and materials. Included in this prospective study were 78 patients where SLO imaging and fundus perimetry were performed with the SLO-105 (Rod enstock) prior to pars plana vitrectomy for macular foramen on one eye. Bot h the size and shape the of macular foramen were assessed. Deep (0 dB) and relative (12 dB) scotomata were tested using the Goldmann II stimulus in th e 20 degrees field of the SLO. Imaging was performed with the infrared lase r and confocal aperture C2. Results. The size of macular foramen ranged from 140 mum to 800 mum (median : 420 mum) and 20 (26%) had irregular, polycyclic borders. In 21 patients ( 27%) a bright sector could be seen just outside the hole. Deep scotomata we re notably smaller than the visible macular hole in 4 patients (6%) and 18 deep scotomata (25%) extended beyond the hole. There was a weak inverse cor relation between the size of deep, relative scotomata and the diameter of t he macular holes with the visual acuity (r=-0.46; r=-0.39 or r=-0.53), but no correlation with the duration of symptoms could be demonstrated. Conclusion. Polycyclic borders were seen as a new feature of some idiopathi c macular foramen. This may be due to asymmetric traction or adhesions on t he macular area. Also, deep scotomata either smaller or larger than the vis ible macular hole were found.