Morphology of macular holes after pars plana vitrectomy with silicone oil endotamponade

作者：Goebel W^*; Guthoff R

来源：Ophthalmologe, 2010, 107(5): 452-459.

DOI：10.1007/s00347-009-2054-6

• Optical coherence tomography
• Macular hole
• Silicone oil
• Vitrectomy
• Retinal imaging

After unsuccessful surgery for macular holes re-vitrectomy is often conducted with silicone oil endotamponade. In the postoperative management uncertainty exists whether the macular hole is actually closed. Standard time domain OCT (Stratus OCT and its predecessors, Carl Zeiss Meditec AG) is rarely successful in depicting the central retina under silicone oil. High resolution Fourier domain OCT (Cirrus OCT) may be superior in delineating macular structures under these conditions.
A total of 10 eyes from 10 patients were examined with the Cirrus OCT (Carl Zeiss Meditec AG) after vitrectomy with silicone oil for persistent macular holes. Sufficiently clear optical media were a prerequisite for the examination. Macular morphology was analyzed under silicone oil and compared with the findings after silicone oil removal.
Of the 10 eyes 5 showed macular hole closure under silicone oil with retinal tissue in the center of the fovea. In 3 eyes there was a shallow subretinal cyst in the center of the fovea and the other 5 eyes showed a persisting hole. The macular hole remained closed after oil removal in all 5 eyes with a foveal contour. In 4 of the other 5 eyes the macular hole reopened and for 1 eye the hole remained stable.
This pilot study showed that the aspect of macular holes under silicone oil seems to influence the prognosis after oil removal. Thus, silicone oil removal as well as further surgery may be planned. The reliable analysis of macular holes under silicone oil has only become possible with high resolution Fourier domain OCT.

• 出版日期2010-5