Thiel M J, Bechmann M, Ullrich S, Gass C, Haritoglou C, Binder C, Kristin N, Lackerbauer C A, Gandorfer A, Ulbig M W
Augenklinik, Ludwig-Maximilians Universität München, Klinikum Innenstadt, Mathildenstrasse 8, 80336 München.
Ophthalmologe. 2000 Dec;97(12):821-6. doi: 10.1007/s003470070001.
Vitreoretinal adhesions play a crucial role in the development of a macular hole. To visualize vitreoretinal adhesion we used optical coherence tomography to investigate fellow eyes of patients with macular holes.
In a prospective study we scanned the retina in 188 patients with a macular hole stage III or IV (Gass classification). The foveal shape and vitreous were classified into grades.
Of the 188 patients 45% showed no vitreous reflex, 45% a partial vitreous detachment with foveolar adhesions, and 10% a vitreous detachment with complete separation from the fovea. While eyes with normal foveolar shape displayed partial vitreous detachment in 33%, this figure rose to 66% in eyes with a macular hole stage I.
Diffuse thickening of the fovea is followed by an intraretinal split and formation of a cyst. The shape of the foveolar adhesion suggests that continuing anteroposterior vitreal traction leads to a retinal break and formation of a full-thickness macular hole.
玻璃体视网膜粘连在黄斑裂孔的形成中起关键作用。为了观察玻璃体视网膜粘连情况，我们使用光学相干断层扫描技术对黄斑裂孔患者的对侧眼进行研究。
在一项前瞻性研究中，我们对188例黄斑裂孔处于III期或IV期（Gass分类）的患者的视网膜进行扫描。对黄斑形状和玻璃体进行分级。
188例患者中，45%未显示玻璃体反射，45%有部分玻璃体脱离伴黄斑粘连，10%有玻璃体脱离且与黄斑完全分离。黄斑形状正常的眼中33%显示部分玻璃体脱离，而在黄斑裂孔I期的眼中这一比例升至66%。
黄斑弥漫性增厚后会出现视网膜内劈裂和囊肿形成。黄斑粘连的形状提示持续的玻璃体前后牵引导致视网膜裂孔和全层黄斑裂孔形成。
