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Case 3-21. Full-thickness Macular Hole with Retinal Detachment

Clinical Summary

A 71-year-old woman was referred for evaluation of a full-thickness macular hole in her right eve. She reported a decline in the visual acuity in this eye, which was assessed at hand motions only, over the past one and one-half weeks. Indirect ophthalmoscopy (A) showed a full* thickness macular hole and a rhegmalogerious retinal detachment extending from two to ten o'clock and involving the macula. Mild, fixed folds were observed interiorly

Optical Coherence Tomography

The OCT scan (B) graphically depicted the separation between the neurosensory retina and retinal pigment epithelium, which seemed to originate nasally and increase temporally in the image. A full-thickness break in the retina was noted, consistent with a macular hole. Small intraretinal cysts were also observed. The optical back-scatter signal from the pigment epithelium and choroid was enhanced directly beneath the macular hole due to increased penetration of the incident and reflected probe light through that region.

250 \im

Temporal

Nasal

Log Reflection

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