Author: Fatma Bağcı (Turkey)
Co-authors: Mehmet Çıtırık, Mehmet Yasin Teke
To compare the vitreomacular interface by SD-OCT optical coherence tomography (OCT) in patients with macular pseudohole (MPH) and idiopathic epiretinal membrane foveaschisis (ERM-Fs).
Retrospective study at the Ophthalmology Department of the University of Health Science, Ankara Ulucanlar Eye Training and Research Hospital, Turkey.
Based on the classification made by the International Vitreomacular Study Group, two groups are included in the report Group 1 includes the cases with MPH diagnosed with OCT images and Group 2 includes the cases with ERM-Fs, whose terminology has not been agreed yet (macular pseudohole with stretched edges, tractional lamellar hole). Accordingly, the study evaluates the presence of epiretinal membrane (ERM), status of the posterior hyaloid [(i) attached on central fovea, detached on the macula; (ii) detached on fovea and macula; (iii) fovea and macula attached], central macular thickness (CMT), central foveal thickness (CFT) and fundus autofluorescence (FAF) pattern (subgrouped as patchy, uniform-oval shaped and mixed).
Thirty-nine eyes of thirty-four patients were included in the study. The mean age was 71.7±9. There were macular pseudohole in 21 eyes (54%) and epiretinal foveaschisis in 18 eyes (46%). All 39 eyes had ERM. In MPH, 17.6% of eyes were attached to the fovea, detached in the macula; 5.9% of eyes were detached on fovea and macula; and 76.5% attached in the fovea and macula. In the ERM-Fs group, it is found that 10% of eyes were attached to the fovea, detached on the macula; 40% of eyes were detached on fovea; and 50% of eyes were attached on the fovea, detached on the macula. CMT was 446.6 ± 50.8 in the MPH group and 571.4±48.7 in the ERM-Fs group, where the difference was statistically significant (p <0.0001). The CFT in OCT was 192.2±13.6 in the MPH group and 198.7±21.9 in the ERM-Fs group. The difference between the two groups was not statistically significant. In FAF images, relatively uniform oval hyperfluorescence (90,5%) in 15 eyes and mixed features in 2 eyes (9,5%) were observed in the fovea in the MPH group, while irregular, patchy hyperfluorescence was observed in all eyes (100%) of the 2nd group (ERM-Fs).
In eyes with ERM-Fs, it was observed that the CMT increased and the posterior hyaloid was separated on the fovea and macula at a higher rate as compared to eyes with MPH. This suggests that separation of the posterior hyaloid may contribute to the formation of foveaschisis in addition to the known ERM contraction effect. Moreover, it can be argued that the patchy FOF pattern detected in all eyes with ERM-Fs correlates with foveoschisis determined in SD-OCT images.