Macular Hole and Vitreomacular Traction

Case 3-20. Lamellar Macular Hole

Clinical Summary

A 61-year-old man was referred for evaluation of a possible macular hole in his left eye. He had noted a gradual decline in his vision for approximately two years. On examination, his visual acuity in the this eye wras 20/ 60. Slit-lamp biomicroscopy (A) showed a red spot in the fovea, but no evidence of a full-thickness hole or an epiretinal membrane.

Optical Coherence Tomography

The contour of the fovea 1 pit was altered on OCT imaging (B); however, the presence of retinal tissue at the base of the fovea ruled out the diagnosis of a full-thickness macular hole. The shape of the contour suggested the rupture of a large macular cyst, consistent with a lamellar hole. The retina surrounding the hole was thickened, reaching a maximum of 370 \xm in the image.

Chapter 3

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