Evaluation of the vitreous body in idiopathic macular holes – biomicroscopic and ultrasonographic picture

Aim of the study
The aim of our study was to estimate the state of the vitreous body and the vitreoretinal interface in patients with idiopathic macular holes.

Material and methods:
We examined 36 patients (41 eyes), 34 women and 2 men aged 65-72 with idiopathic macular holes. State of the hole (classified by Gass) was established on the biomicroscopical examination using Goldmann lens and double aspheric Volk lenses (+60,0, +90,0 D), ultrasonography Compuscan UAB 1000 Storz and fluorescein angiography.

Results:
We classified stage 2 macular hole in 7 eyes (17%), stage 3 in 28 eyes (68%) and stage 4 in 6 eyes (15%). In the slit lamp examination we revealed partial posterior hyaloid detachment with posterior hyaloid membrane still attached at optic nerve head in 5 eyes, vitreomacular separation in 3 eyes, and vitreofoveal separation of posterior hyaloid membrane with the presence of focal condensation of the posterior hyaloid membrane in front of the fovea – operculum in 11 eyes, in stage 3 macular hole. In 8 eyes we observed lacunaes, and vitreoretinal tractions in 6. Ultrasonography was slightly more effective in revealing vitreomacular and partial PVD separation than biomicroscopical examination. In the case of vtireoretinal tractions or lacunaes, ultrasonography was worse than slit lamp examination.

Conclusions:
The exact evaluation of condition of the vitreous body and vitreo-retinal relationships are crucial for a further surgical treatment.