Diagnosis of macular pseudoholes and lamellar macular holes by optical coherence tomography
Section snippets
Design
This study was an observational case series.
Setting
Institutional practice.
Patients
We retrospectively reviewed the files of 71 eyes of 70 consecutive patients who were examined between 1999 and 2002 and were diagnosed as having a pseudohole or lamellar hole on OCT examination. They included 31 men and 39 women. Their mean age was 67 years (range, 17–85). These patients were referred to our department because, on biomicroscopy, they appeared to have a hole in the macula. On examination, the diagnosis of full-thickness macular hole was ruled out, from the
Results
On biomicroscopy, 49 of the 71 eyes were diagnosed as having MPH. This diagnosis was based on the presence of a well-delineated round or oval image of the macula and in eyes which had a definite ERM with retinal folds. Ten eyes were diagnosed as having LMH combined with a pseudo-operculum. The diagnosis of LMH was based on the presence of a round or petal-shaped reddish lesion with flat edges which was sharply circumscribed. The reddish center seemed slightly depressed, although the depression
Discussion
Macular pseudoholes and LMH are two well-known differential diagnoses of FMTH. As FTMH became a treatable condition, more attention was paid to its characteristics, and Gass9, 10 has thoroughly analyzed the criteria which allow impending or FTMHs to be distinguished from lesions simulating a macular hole. In most cases, careful biomicroscopy slit-lamp examination with a contact lens makes it possible to diagnose FTMH. The Watzke-Allen test11 may be useful when it is frankly positive (i.e., when
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