AAO Digital GUIDELINES Apps (free trial)

Idiopathic Macular Hole

AAO GUIDELINES App brought to you courtesy of Guideline Central. All of these titles are available for purchase on our website, GuidelineCentral.com. Enjoy!

Issue link: https://eguideline.guidelinecentral.com/i/616782

Contents of this Issue

Navigation

Page 4 of 11

Table 2. Stages and Characteristics of Macular Holes Stage Characteristics 1-A (impending ) • Loss of the foveal depression and a yellowish foveal spot (100–200 µm in diameter) • Localized shallow detachment of the perifoveal vitreous cortex with persistent adherence to the foveola • Vitreofoveolar traction may horizontally separate (split) the retina at the fovea (pseudocyst) that corresponds to the yellow spot • Epiretinal membranes are uncommon • Visual acuity ranges from 20/25 to 20/80 • Surgical intervention is NOT recommended 1-B (impending ) • Yellow ring 200–350 µm in diameter • Posterior extension of the pseudocyst with disruption of the outer retinal layer • The retinal roof remains intact with persistent adherence of the posterior hyaloid to the retina • Epiretinal membranes are uncommon • Visual acuity ranges from 20/25 to 20/80 • Surgical intervention is NOT recommended 2 • Small full-thickness (<400 µm in diameter) retinal defect • Epiretinal membranes are uncommon • Visual symptoms include metamorphopsia and decreased vision • Visual acuity 20/25 to 20/80 3 • Full-thickness hole ≥400 µm in diameter • The posterior hyaloid is separated from the macula but may remain attached at the optic disc and be attached more peripherally • An operculum or a flap is present on the posterior hyaloid over the hole and is visible clinically or by optical coherence tomography (OCT) • A cuff of subretinal fluid may be detected along with intraretinal edema and cysts • Drusen-like deposits a may occasionally be seen in the base of the hole • A rim of retinal pigment epithelium hyper/hypopigmentation is often present at the junction between edematous or detached retina and normal- appearing attached retina in long-standing cases • Epiretinal membranes may be present • Visual acuity usually ranges from 20/100 to 20/400 4 • A full-thickness hole with a diameter usually larger than stage 3 (>400 µm) • A complete posterior vitreous detachment with a Weiss ring • A cuff of subretinal fluid, intraretinal edema, and cystoid changes are usually present • Drusen-like deposits a may occasionally be seen in the base of the hole • Epiretinal membranes are more frequent • Visual acuity is more profoundly decreased from 20/100 to 20/400 a Drusen-like or yellow deposits may represent macrophages at the level of the retinal pigment epithelium, suggesting chronicity of disease.

Articles in this issue

Archives of this issue

view archives of AAO Digital GUIDELINES Apps (free trial) - Idiopathic Macular Hole