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Br J Ophthalmol 2008;92:635-639 doi:10.1136/bjo.2007.127597
  • Clinical science
    • Original Article

Diagnosis of macular pseudoholes and lamellar macular holes: is optical coherence tomography the “gold standard”?

  1. F Bottoni,
  2. L Carmassi,
  3. M Cigada,
  4. S Moschini,
  5. F Bergamini
  1. Department of Ophthalmology, S Giuseppe Hospital, Italy
  1. Dr F Bottoni, Department of Ophthalmology, S Giuseppe Hospital, Via S Vittore 12, 20123 Milan, Italy; ferdinando.bottoni{at}fastwebnet.it
  • Accepted 17 November 2007
  • Published Online First 1 February 2008

Abstract

Aim: To assess fundus autofluorescence (AF) for differential diagnosis of macular pseudoholes (MPH) and lamellar macular holes (LMH) evaluated by optical coherence tomography (OCT) as the “gold standard”.

Methods: The files on 50 eyes of 46 consecutive patients diagnosed by OCT as having a foveal defect with residual retinal tissue at the bottom were reviewed. Retinal thickness was measured at the foveal centre and 750 μm temporally and nasally to differentiate further MPH and LMH. The corresponding corrected AF images were then evaluated. Eyes with either macular pucker or stage 1a impending macular hole served as controls.

Results: OCT measurements allowed the classification of two different profiles: 28 eyes classified with MPH had macular centres and perifoveal retinas that were significantly thicker than the 22 eyes classified with LMH. The corrected value of the foveal AF intensity was not significantly different between the two groups. In addition, the AF did not correlate with the thickness of the retinal tissue at the base of either MPH or LMH eyes. None of the control eyes showed foveal AF.

Conclusions: The findings suggest that OCT data must be interpreted with caution when differentiating between MPH and LMH. In this series, the two groups showed similar foveal AF. AF imaging may add useful information to the differential diagnosis of MPH from LMH: the presence of foveal AF is consistent with a loss of foveal tissue and therefore a diagnosis of LMH.

Footnotes

  • Presented in part at the 25th meeting of the Club Jules Gonin, 15-20 October 2006, Cape Town, South Africa

  • Funding: None.

  • Competing interests: None declared.

  • Ethics approval: Ethics approval was obtained.

Responses to this article

  • Author's response
    • Ferdinando Bottoni
    Br J Ophthalmol published online July 29, 2009
  • Quantitative Analyses of Fundus Autofluorescence
    • Ali Ayata,
    • Sinan Tatlipinar, Melih Unal, Dilaver Ersanli, Ahmet H Bilge
    Br J Ophthalmol published online July 29, 2009

This Article

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