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Macular Hole and Vitreomacular Traction

Case 3-15. Stage 4 Macular Hole

Clinical Summary

A 73-year-old woman had a full-thickness macular hole in her left eye associated with a visual acuity of counting fingers at 7 feet (A),

Optical Coherence Tomography

The OCT image (B) showed a large full-thickness hole with significant surrounding retinal edema. The retinal thickness at the edge of the hole measured 500 |am. The posterior hyaloid membrane was completely separated from the retina by approximately 350 f^ni consistent with a Stage 4 classification. The hole diameter was 660 pm at its minimum point in the image.

Chapter 3

Case 3-16. Macular Hole arid Age-Related Macular Degeneration

Clinical Summary

A 72-year-old man with age-related macular degeneration was referred for difficulty reading and worsening visual acuity in the left eye, which was assessed at counting fingers at three feet. Slit-lamp biomicroscopy (A) revealed a fibrovascular scar in the central macula with no evidence of subretinal fluid or hemorrhage. A small, full-t hickness macular hole was also observed centrally Fluorescein angiography (B) demonstrated a hyperfluorescent area in the central macula with late staining but no leakage or pooling, consistent with a disciform scar

Optical Coherence Tomography

OCT examination (C) confirmed a full-thickness macular hole in the fovea. Retinal atrophy was noted surrounding the hole and the retinal thickness measured at the temporal margin of the hole was 130 \tm. The reflective band corresponding to the retinal pigment epithelium and cho-riocapillaris was thickened in the central macula consistent with a disciform scar

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