Zusammenfassung
Nach der traditionellen Stadieneinteilung von Makulaforamina (MF) nach Gass ergeben sich durch das OCT zusätzliche und genauere morphologische Kenntnisse von Makulaforamen. Als primärer Pathomechanismus der Makulaforamenentstehung wird eine perifoveale GK-Abhebung mit anteriorer fovealer Glaskörpertraktion angenommen. Bei persistierender Traktion kann diese zur foveolären Dehiszenz führen. Eine mögliche Erklärung für die intraretinale Zystenbildung ist die Hydratation der Fovea durch Glaskörperflüssigkeit. Aufgrund zusätzlicher Befunde aus dem OCT ist eine Klassifikation von MF möglich. Das OCT bei MF ist eine wertvolle Hilfe für die Differenzialdiagnose (Pseudomakulaforamen — echtes MF), präzise Stadieneinteilung, Therapieentscheidung, Erfolgskontrolle nach Makulachirurgie und als Prognoseindikator.
Abstract
The traditional Gass classification of macular holes can now be supplemented by additional and more detailed morphologic information obtained with optical coherence tomography (OCT). The perifoveal vitreous detachment and subsequent anterior foveal traction is considered to be the primary pathomechanism of macular hole formation. In cases of persistent traction on the fovea it may lead to foveal dehiscence. A possible explanation for intraretinal cyst formation may be secondary vitreous body fluid accumulation within the retina. A classification of macular holes based on additional information from OCT images is possible. Thus, OCT is a valuable tool for differential diagnosis of a pseudo macular hole versus macular hole, precise stage classification, therapy decision making process, outcome control after macular surgery, and prognosis prediction.
Literatur
Ansari H, Rodriquez-Coleman H, Langton K, Chang S (2002) Spontaneous resolution of bilateral stage 1 macular holes documented by optical coherence tomography. Am J Ophthalmol 134:447–449
Azzolini C, Patelli F, Brancato R (2001) Correlation between optical coherence tomography data and biomicroscopic interpretation of idiopathic macular hole. Am J Ophthalmol 132:348–355
Chauhan DS, Antcliff RJ, Rai PA, Williamson TH, Marshall J (2000) Papillofoveal traction in macular hole formation: the role of optical coherence tomography. Arch Ophthalmol 118:32–38
Costa RA, Cardillo JA, Morales PH, Jorge R, Uno F, Farah ME (2001) Optical coherence tomography evaluation of idiopathic macular hole treatment by gas-assisted posterior vitreous detachment. Am J Ophthalmol 132:264–266
Dai H, Li Y, Long L, Di Y, Lu Y, Wang Z (2002) The observation on detachment of posterior hyaloid membrane in idiopathic macular holes by optical coherence tomography. Zhonghua Yan Ke Za Zhi 38:667–669
Demols P, Schrooyen M (2003) Analysis of optical coherence tomography for macular hole closure after surgery. Bull Soc Belge Ophtalmol 288:25–29
Ebato K, Kishi S (2000) Spontaneous closure of macular hole after posterior vitreus detachment. Ophthalmic Surg Lasers 31:245–247
Gallemore RP, Jumper JM, McCuen B, Jaffe GJ, Postel EA, Toth CA (2000) Diagnosis of vitreoretinal adhesions in macular disease with optical coherence tomography. Retina 20:115–120
Gass JDM (1997) Stereoscopic atlas of macular diseases, diagnosis and treatment. Mosby 4th edn, p 903f
Gaudric A, Haouchine B, Massin P, Paques M, Blain P, Erginay A (1999) Macular hole formation: new data provided by optical coherence tomography. Arch Ophthalmol 117:744–751
Gobel W, Schrader WF, Schrenker M, Klink T (2000) Befunde der optischen Kohärenz-Tomogaphie (OCT) vor und nach Makulalochchirurgie. Ophthalmologe 97:251–256
Hassenstein A, Rühl R, Richard G (2001) Optische Kohärenztomographie bei geographischer Atrophie — eine klinisch-pathologische Korrelation. Klin Monatsbl Augenheilkd 218:503–509
Haouchine B, Massin P, Gaudric A (2001) Foveal pseudocyst as the first step in macular hole formation — a prospective study by optical coherence tomography. Ophthalmology 108:15–22
Imai M, Iijima H, Gotoh T, Tsukahara S (1999) Optical coherence tomography of successfully repaired idiopathic macular holes. Am J Ophthalmol 128:621–627
Imai M, Ohsiro T, Cotoh T, Imasawa M, Iijima H (2003) Spontaneous closure of stage 2 macular hole observed with optical coherence tomography. Am J Ophthalmol 136:187–188
Ito Y, Terasaki H, Suzuki T, Kojima T, Mori M, Ishikawa K, Miyake Y (2003) Mapping posterior vitreous detachment by optical coherence tomography in eyes with idiopathic macular hole. Am J Ophthalmol 135:351–355
Kang SW, Ahn K, Ham DI (2003) Types of macular hole closure and their clinical implications. Br J Ophthalmol 87:1015–1019
Kasuga Y, Arai J, Akimoto M, Yoshimura N (2000) Optical coherence tomography to confirm early closure of macular holes. Am J Ophthalmol 130:675–676
Liu X, Ling Y, Gao R, Zhao T, Huang J, Zheng X (2003) Optical coherence tomography’s diagnostic value in evaluating surgical impact on idiopathic macular hole. Chin Med J 16:444–447
Madreperla SA, Brooks W, McCuen B (1999) Macular hole — pathogenesis, diagnosis and treatment. Butterworth Heinemann Boston Oxford p 18ff, p 77ff
Mikajiri K, Okada AA, Ohji M et al. (1999) Analysis of vitrectomy for idiopathic macular hole by optical coherence tomography. Am J Ophthalmol 128:655–657
Ripandelli G, Coppe AM, Bonini S, Giannini R, Curci S, Costi E, Stirpe M (1999) Morphological evaluation of full-thickness idiopathic macular holes by optical coherence tomography. Eur J Ophthalmol 9:212–216
Sato H, Kawasaki R, Yamashita H (2003) Observation of idiopathic full-thickness macular hole closure in early postoperative period as evaluated by optical coherence tomography. Am J Ophthalmol 136:185–187
Shaikh S, Garretson B (2003) Spontaneous closure of a recurrent macular hole following vitrectomy corroborated by optical coherence tomography. Ophthalmic Surg Lasers Imaging 34:172–174
Spiritus A, Dralands O, Stalmans P, Stalmans I, Spileers W (2000) OCT study of fellow eyes of macular holes. Bull Soc Belge Ophtalmol 275:81–84
Takahashi H, Kishi S (1999) Optical coherence tomography images of spontaneous macular hole closure. Am J Ophthalmol 128:519–520
Takahashi H, Kishi S (2000) Tomographic features of early macular hole closure after vitreous surgery. Am J Ophthalmol 130:192–196
Tanner V, Williamson TH (2000) Watzke-Allen slit beam test in macular holes confirmed by optical coherence tomography. Arch Ophthalmol 118:1059–1063
Tornambe PE (2003) Macular hole genesis: the hydration theory. Retina 23:421–424
Yamada H, Sakai A, Yamada E, Nishimura T, Matsumura M (2002) Spontaneous closure of traumatic macular hole. Am J Ophthalmol 134:340–347
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OCT-Viewer® ist ein Produkt der Firma Datamedical Consulting. Frank Scholz ist Geschäftsführer von Datamedical Consulting (Friedensallee 100c, 22763 Hamburg; Scholz@datamedicel.de)
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Hassenstein, A., Scholz, F. & Richard, G. OCT bei Makulaforamen. Ophthalmologe 101, 777–784 (2004). https://doi.org/10.1007/s00347-004-1053-x
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DOI: https://doi.org/10.1007/s00347-004-1053-x