Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Retina. 2011 Jan;31(1):127-47. doi: 10.1097/IAE.0b013e3181e7997b.
To determine the anatomical morphology of Stage 1-A impending macular holes characterized by a yellow spot using spectral-domain optical coherence tomography to study the fellow eyes of patients diagnosed with a full-thickness macular hole or eyes with a typical yellow spot with metamorphopsia.
Prospective observational case series of 45 patients with a full-thickness macular hole or a foveolar yellow spot with metamorphopsia. Visual acuity assessment, biomicroscopic examination, and spectral-domain optical coherence tomography were performed. Clinical ophthalmologic examinations were repeated, including spectral-domain optical coherence tomography, in the eyes with a foveolar yellow spot at 1-month interval.
We examined 43 fellow eyes of 43 patients with a macular hole and 2 eyes of 2 patients with a foveolar yellow spot. Five fellow eyes had a yellow spot. Spectral-domain optical coherence tomography clearly showed the reflectivity of the perifoveal posterior vitreous detachment with vitreofoveal adhesion in the 7 eyes with a yellow spot; the foveal microstructure had a triangular foveolar detachment of the cone outer segment tip line, of which only 2 eyes (29%) had foveal splits during the observational period, 3 eyes (43%) had a foveal perpendicular line, and 4 eyes (57%) showed progression to vitreofoveal separation before the development of inner splits or pseudocysts. In those 7 eyes, the 2 eyes (29%) with foveal splits progressed to a full-thickness macular hole. The 38 fellow eyes without a yellow spot had no foveolar detachment.
The foveolar detachment of the cone outer segment tip line might be responsible for the yellow spot seen in Stage 1-A macular holes.
使用谱域光相干断层扫描观察全层黄斑裂孔或伴有变形的典型黄斑区黄色斑点患者的对侧眼，以确定 1 期 A 期黄斑裂孔伴黄斑中心凹黄色斑点的解剖形态。
对 45 例全层黄斑裂孔或黄斑中心凹黄色斑点伴变形的患者进行前瞻性观察性病例系列研究。进行视力评估、生物显微镜检查和谱域光相干断层扫描。对伴有黄斑中心凹黄色斑点的眼进行 1 个月间隔的临床眼科检查，包括谱域光相干断层扫描。
我们检查了 43 例黄斑裂孔患者的 43 只对侧眼和 2 例黄斑中心凹黄色斑点患者的 2 只眼。有 5 只对侧眼有黄色斑点。谱域光相干断层扫描清楚地显示了 7 只眼中黄色斑点的周边后玻璃体脱离的反射性和玻璃体黄斑粘连；黄斑微观结构有一个三角形的黄斑中心凹圆锥外节尖端线脱离，只有 2 只眼（29%）在观察期间出现黄斑裂孔，3 只眼（43%）有黄斑垂直线，4 只眼（57%）出现玻璃体黄斑分离前进展到玻璃体黄斑分离，然后出现内部分离或假性囊肿。在这 7 只眼中，有黄斑裂孔的 2 只眼（29%）进展为全层黄斑裂孔。38 只无黄色斑点的对侧眼无黄斑中心凹脱离。
黄斑中心凹圆锥外节尖端线的黄斑中心凹脱离可能是 1 期 A 期黄斑裂孔中所见黄斑中心凹黄色斑点的原因。
