2M.D., Celal Bayar University, Faculty of Medicine, Department of Ophthalmology, Manisa/TURKEY
3M.D., Professor, Celal Bayar University, Faculty of Medicine, Department of Ophthalmology, Manisa/TURKEY Purpose: To compare the vitreoretinal interface of the asymptomatic fellow eyes of patients with unilateral idiopathic macular holes (MH) with the asymptomatic fellow eyes of patients with idiopathic epiretinal membranes (ERM) and with the healthy eyes.
Materials and Methods: Thirty-tree patients with unilateral MH (group 1), 33 patients with unilateral ERM (group 2) and 33 healthy eyes were included in the study. All patients underwent a comprehensive ophthalmologic examination and spectral domain optical cohorence tomography (OCT) was performed on all eyes. The incidence of the features of the vitreoretinal interface and foveal micro-structures in the OCT images were compared among the asymptomatic fellow eyes of patients with unilateral MH, ERM and one of the randomly selected healthy eyes of normal individuals which have any ophthalmic pathology except refractive errors. A complete posterior vitreus detachment (PVD) was considered to be present if the Weiss ring was seen on biomicroscopy or a hiper-reflective band representing a posterior hyaloid membrane over the entire macula was seen on OCT.
Results: The incidence of perifoveal PVD was 45.5% in group 1, 21.2% in group 2 and 24.2% in group 3. The OCT scans showed different types of foveal deformations associated with vitreofoveal adhesions in eyes without a total PVD. The incidence of the foveal deformations associated with vitreofoveal adhesions was significantly higher (p<0.039) in the fellow eyes of the unilateral MH group (27%) than that in the other groups (0%). The OCT scans also showed residual foveal deformations in eyes with total PVD. The incidence of residual foveal deformation in eyes with total PVD was similar between MH and ERM groups (33%-27%, p=0,75), but it was significantly higher in the MH (33%) and ERM (27%) groups than that in healthy eyes (19%, p<0.01).
Conclusion: The higher incidence of foveal deformations in the asymptomatic fellow eyes of patients with unilateral MH with vitreofoveal adhesions suggests that patients in whom MH may develop have abnormally strong vitreofoveal adhesions sufficient to cause foveal deformation and macular holes.
Keywords : Epiretinal membrane, macular hole, optical coherence tomography, vitreoretinal interface