Inner lamellar macular holes vs macular pseudoholes with normal foveal thicknesses / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

Aim To compare quantitative data and imaging of inner lamellar macular holes (ILHs) and macular pseudoholes (MPHs) with normal foveal thickness, both associated with epiretinal membranes (ERM). Methods In 27 eyes (25 consecutive patients) with ERM at the macula and a clinical appearance of a macular hole or MPH, the foveal thickness and contour were evaluated with optical coherence tomography (OCT). At least two measurements offoveal thickness of ≥135 μμ m each at two different scans were prerequisites in these eyes for diagnosis of a MPH, and a foveal thickness ＜135 ＞0 μ m was diagnosed as an ILH. Eyes with MPH with foveal thickness ＞202 μ m, eyes with full-thickness macular holes and eyes with vitreo-macular adhesions or other macular abnormalities that could affect the data were excluded from the analysis. Results Inner lamellar macular holes were detected in 6 eyes (22.2 %) of 6 patients (mean age,56 ± 18 [s] years), and MPHs with normal foveal thickness (NT-MPHs) were diagnosed in 4 eyes (14.4%) of 4 patients (mean age, 70 ±9years). The minimal foveal thicknesses at the ILHs and NT-MPHs ranged from 74 to 108 μ m (mean, 87 ±12.6) and from 135 to 191 μμ m (mean, 166 ± 27), respectively. At the bases of each NT-MPH and of 4 of the 6 eyes with ILH cystoid changes were detected. All other 17eyes had a foveal thickness ＞203 μ m in each, associated with more prominent cystoid changes at the fovea. Conclusion The quantitative findings of the ILHs using OCT could differentiate them from NT-MPHs. The findings suggest that ILHs with cystoid changes may thicken to become MPH. The quantitative data and repeated evaluations during follow-up may prove objective changes that can help in decision-making regarding indication and timing of surgery for ERMs with cystic foveal changes.