Operculum Retina

Case 3-7 continued

Clinical Summary

Dilated fundus examination D) of the patient's right eye revealed mild mottling of the retinal pigment epithelium and an apparently attached vitreous, A subtle cyst or pseudohole was observed in the fovea. The patient's visual acuity in this eye was 20/25. Fluorescein angiography (E) appeared normal

Optical Coherence Tomography

OCT examination (F) demonstrated an elevation of the inner retina above an optically clear space consistent with a cvst direct!v in the fovea. The minimally reflective band j J J

corresponding to the posterior hyaloid appeared to be attached to the fovea, but separated from the more peripheral retina by approximately 300 \xm. This finding was not visible ophthalmoscopylly.

Case 3-8. Stage 3 Macular Hole with a Posterior Vitreous Detachment in the Fellow Eye

Clinical Summary

A 65-year-old woman presented with a Stage 3 macular hole in her left eye associated with a visual acuity of 20/200 (A). An area of retinal pigmental epithelial atro-phv was noted superotemporal to the macula.

Tomography

An OC I tomogram (B) through the macula delineated a full-thickness hole with a minimal surrounding retinal edema. The retinal thickness was 360 jam at the edge of the hole.

Case 3-8 continued

Clinical Summary

The patient's fellow eye was normal on slit-lamp examination (O with a visual acuity of 20/20.

Optical Coherence Tomography

OCT (D) also showed a healthy fovea. The posterior vitreous face was observed to be detached from the retina, including the fovea, by approximately 500 |im indicating a negligible risk of macular development in this eye.

Case 3-9. Stage 3 Macular Hole with a Posterior Vitreous Detachment in the Fellow Eye

Clinical Summary

A 68-year-old man had a Stage 3 full-thickness macular hole in his left eye with a surrounding halo of macular edema (A). Hyperfluorescence in the fovea was observed on fluorescein angiography (B) consistent with a central window defect-

Optical Coherence Tomography

A horizontal OCT section iC) revealed a full-thickness loss of retinal tissue in the fovea with an inner diameter of approximately 275 (am . A small piece of tissue consistent with an operculum appeared about 500 Jim anterior to the retina. An operculum was not visible biomicroscopically. Large cystic spaces and fluid accumulation in the outer retinal la vers were observed in the retina just surrounding the hole.

Case 3-9 continued

Clinical Summary

Examination of the patient's right eye showed no abnormalities on slit-lamp biomicroscopy (DL

Optical Coherence Tomography

An OCT tomogram (E) obtained through the macula illustrated a normal fovea with a small (approximately 150 jim) detachment of the posterior vitreous. The reflection from the posterior hyaloid was faint just above the fovea, but suggested a complete vitreous detachment and a re- D

duced or negligible risk of hole development in this fellow eye. jf

Case 3-10. Stage 3 Macular Hole with a Pseudo-operculum in the Fellow Eye

Clinical Summary

A 72-year-old woman was examined seven months after undergoing pars plana vitrectomy and membrane peeiing for a Stage 3 macular hole. Slit-lamp biomicroscopy (A) revealed that the hole was still patent- Her visual acuity in this eye was 20/400.

Optical Coherence Tomography

A vertical OCT section (B) showed a narrow (approximately 150 ^m diameter at its minimum in the image) tull-thickness hole with a large surrounding region of retinal edema and detachment. The retinal thickness reached a maximum of 420 jjim in the image.

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