Elsevier

Ophthalmology

Volume 102, Issue 5, May 1995, Pages 748-756
Ophthalmology

Optical Coherence Tomography of Macular Holes

https://doi.org/10.1016/S0161-6420(95)30959-1Get rights and content

Purpose: To assess the potential of a new diagnostic technique called optical coherence tomography (OCT) for diagnosing and monitoring macular holes. This technique is a novel noninvasive, noncontact imaging modality that produces high longitudinal resolution (10-μm) cross-sectional tomographs of ocular tissue.

Methods: Optical coherence tomography is analogous to ultrasound except that optical rather than acoustic reflectivity is measured. Cross-sectional tomographs of the retina profiling optical reflectivity in a thin, optical slice of tissue are obtained with a longitudinal resolution of 10 μm. Optical coherence tomography was used to examine 49 patients with the clinical diagnosis of idiopathic full-thickness macular hole, impending macular hole, epimacular membrane with macular pseudohole, or partial-thickness hole. The resulting OCTs were correlated with contact lens and slit-lamp biomicroscopy, fundus photography, and fluorescein angiography.

Results: The cross-sectional view produced by OCT was effective in distinguishing full-thickness macular holes from partial-thickness holes, macular pseudoholes, and cysts. Optical coherence tomography was successful in staging macular holes and provided a quantitative measure of hole diameter and the amount of surrounding macular edema. Optical coherence tomography also was used to evaluate the vitreoretinal interface in patients' fellow eyes and was able to detect small separations of the posterior hyaloid from the retina.

Conclusion: Optical coherence tomography appears potentially useful as a new, noninvasive, diagnostic technique for visualizing and quantitatively characterizing macular holes and assessing fellow eyes of patients with a macular hole. The tomographc information provided by OCT eventually may lead to a better understanding of the pathogenesis of macular hole formation.

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Supported in part by NIH grant RO-1-GM35459-08, Bethesda, Maryland, MFEL grant N00014-91-C-0084, Arlington, Virginia, an unrestricted departmental grant from Research to Prevent Blindness, New York, New York, and the Massachusetts Lions Eye Research Fund, Inc, Boston, Massachusetts. Mr. Hee is an MD-PhD student in the Division of Health Sciences and Technology, Harvard Medical School.

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Drs. Puliafito and Fujimoto are consultants for Humphrey Instruments, Inc.

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