Haouchine Belkacem, Massin Pascale, Tadayoni Ramin, Erginay Ali, Gaudric Alain
Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université, Paris, France.
Am J Ophthalmol. 2004 Nov;138(5):732-9. doi: 10.1016/j.ajo.2004.06.088.
To assess the usefulness of optical coherence tomography (OCT) for better differential diagnosis of macular pseudoholes (MPH) and lamellar macular holes (LMH).
Observational case series.
setting: Institutional practice. patients: We reviewed the files of 71 eyes of 70 consecutive patients who were diagnosed as having a pseudohole or lamellar hole on OCT examination. All patients referred for suspected pseudohole or lamellar hole on biomicroscopy were evaluated by OCT. main outcome measures: Each eye underwent six radial 3-mm OCT scans centered on the macula, one 6-mm vertical and one 6-mm horizontal scan. Retinal thickness was measured at the foveal center and 750 microm from the center, vertically, and horizontally. The diameter of the macular contour was also measured on vertical and horizontal scans.
In 40 cases, OCT showed a macular profile characteristic of MPH: a steepened foveal pit combined with thickened foveal edges and a small foveal pit diameter. Central foveal thickness was normal or slightly increased (167 +/- 42 microm). Mean perifoveal thickness was greater than normal (363 +/- 65 microm). In 29 other cases corresponding to LMH, OCT showed a profile characterized by a thin irregular foveal floor, split foveal edges, and near-normal perifoveal retinal thickness. Central foveolar thickness was thinner than normal (72 +/- 19 microm). Mean perifoveal thickness was near normal (283 +/- 36). Optical coherence tomography did not allow the classification of the remaining two cases.
Optical coherence tomography is very useful in distinguishing MPH attributable to epiretinal membrane contraction from LMH because of partial opening of a macular cyst.
评估光学相干断层扫描（OCT）在黄斑假性裂孔（MPH）和板层黄斑裂孔（LMH）鉴别诊断中的应用价值。
观察性病例系列。
机构实践。患者：我们回顾了70例连续患者的71只眼，这些患者经OCT检查诊断为假性裂孔或板层裂孔。所有因生物显微镜检查怀疑假性裂孔或板层裂孔而转诊的患者均接受了OCT评估。主要观察指标：每只眼进行6次以黄斑为中心的3毫米径向OCT扫描、1次6毫米垂直扫描和1次6毫米水平扫描。在黄斑中心凹中心以及距中心垂直和水平方向750微米处测量视网膜厚度。还在垂直和水平扫描上测量黄斑轮廓的直径。
40例中，OCT显示出MPH的黄斑特征：中心凹坑变陡，伴有中心凹边缘增厚和中心凹坑直径较小。中心凹厚度正常或略有增加（167±42微米）。平均中心凹周围厚度大于正常（363±65微米）。在另外29例对应于LMH的病例中，OCT显示出的特征为中心凹底部薄且不规则、中心凹边缘裂开以及中心凹周围视网膜厚度接近正常。中心凹厚度比正常薄（72±19微米）。平均中心凹周围厚度接近正常（283±36）。OCT无法对其余2例进行分类。
光学相干断层扫描在区分由视网膜前膜收缩引起的MPH和因黄斑囊肿部分开放导致的LMH方面非常有用。
