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OCT allows differentiation between lamellar macular holes and macular pseudoholes
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PARIS — Optical Coherence Tomography has emerged as a useful tool for the correct identification of lamellar holes, a speaker said here.
"Lamellar macular holes are partial-thickness foveal defects defined by an absence of the inner macular tissue in the region of the foveola," Marta S. Figueroa, MD, said at the Euretina meeting preceding the European Society of Cataract and Refractive Surgeons meeting. "Due to a similar appearance on biomicroscopy, they are easily confused with macular pseudoholes. Functional tests are not always useful for distinguishing between these two entities."
The profile of lamellar holes on OCT is characterized by an irregular, asymmetric foveal contour, a break in the inner fovea and a separation of the inner from the outer foveal layer, leading to an intraretinal split, he said. In contrast, macular pseudoholes show a verticalization of the foveal margin, giving the fovea a cylindrical appearance with a steepened foveal pit.
"The correct diagnosis of lamellar holes is difficult in the absence of the information provided by OCT. Revision of previous series showed that in a high percentage of cases, what was diagnosed as lamellar holes were in fact pseudoholes," Dr. Figueroa said.