Macular Hole Syndromes: Echographic Findings with Clinical Correlation

Background: Anatomic characteristics of macular holes may be difficult to define, even with contact lens biomicroscopy. With the advent of successful macular hole surgical techniques, accurate diagnosis has become increasingly important to avoid unnecessary or incorrect surgery. Echography may provide additional diagnostic information in some cases. The purpose of this study is to correlate echographic and intraoperative clinical features of macular holes. Methods: The echographic features and intraoperative findings in 25 patients were compared. The spectrum of identifiable echographic features included (1) a thin, smooth, membrane-like surface minimally elevated over the macula (limited posterior vitreous face separation); (2) macular thickening; (3) an operculum; and (4) a complete posterior vitreous face separation. Intraoperative clinical findings included the presence or absence of (1) a thin, limited posterior vitreous face separation, (2) a subretinal fluid cuff, (3) an operculum, and (4) a complete posterior vitreous face separation. Results: Echographic and intraoperative findings correlated regarding the limited posterior face separation in 23 of 25 patients, a surrounding subretinal fluid cuff (macular thickening) in 24 of 25 patients, an operculum in 19 of 25 patients, and complete posterior vitreous face separation in 24 of 25 patients. Thus, echography was very effective in detecting the position of the posterior vitreous face. Overall, echography correlated accurately with 90 (90%) of 100 of these four features. Conclusion: Echographic features correlate accurately with clinical features.