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Spontaneous macular hole
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This retinal photograph and ocular coherence tomography image were chosen as the winner of this month’s “Ocular Photography Challenge.”
Mark R. Flora, OD, of Hampstead, N.C., said this stage 4 macular hole occurred spontaneously in a 61-year-old Caucasian female patient in 2009.
“The visual acuity in this eye is a surprising 20/125, and the patient suffers from a central scotoma as well as a 3+ nuclear sclerotic cataract,” he said. “Easily seen is the ‘punched out’ full thickness hole that is 400 microns in diameter, surrounding fluid cuff (neurosensory retinal detachment) and white clumps of proliferating glial cells. The offending epiretinal membrane can be seen temporally.
“Not shown is the resultant operculum of macular tissue that is suspended in the overlying posterior vitreous,” he continued. “The OCT depicts these features and, most importantly, that the vitreous is no longer attached to the edges of the hole, indicating that no progression is likely.
Dr. Flora said that the patient declined vitrectomy and gas bubble tamponade but did undergo uncomplicated extracapsular cataract extraction with posterior chamber IOL implantation in this eye, after which the retinal photograph was taken with a Cannon CRTA fundus camera by Elizabeth Muraca, one of his assistants.
As this month’s winner, Dr. Flora will receive an HA-2 Handheld Tonometer, provided by Kowa.
Submissions for the contest can be e-mailed to nhemphill@slackinc.com. They are judged anonymously by a panel of Primary Care Optometry News Editorial Board members.
Please provide a photo of at least 300 dpi, a 100-word description of the case including what imaging system was used and the name of your home town. Photos may not have been previously published. You will be asked to grant permission to SLACK Inc. to publish your photo.
Contestants are permitted to win once a year. Kowa provides the prizes, including one annual grand prize awarded to the winner chosen from among each round’s winners. Delivery of prizes may take up to 120 days.