Macular Holes

The most common form of angle-closure glaucoma is relative pupillary block. In relative pupillary block, aqueous pressure behind the iris plane forces the iris anteriorly. Elimination of this pressure gradient can be achieved with laser iridotomy. A second, less common form of angle-closure glaucoma is known as plateau iris syndrome. In plateau iris, the iris is forced into the angle by the presence of an abnormally placed, anterior ciliary body. Because this form of angle-closure is not due to fluid pressure gradient, it responds poorly to laser iridotomy. If undiagnosed, recurrent angle-closure may develop. Other forms of angle-closure of interest to clinicians include lens-induced angle-closure, iris cysts, iris tumors, ciliary body rotation due to effusion, dark room provocative testing during ultrasound biomicroscopy, malignant glaucoma.

Macular holes are characterized by partial or complete absence of retinal tissue. OCT can provide information about staging and the relationship of the posterior hyaloid to the development of the hole. In this preoperative image, a full-thickness hole with cyst formation within the retina is visible.

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OCT appearance of the above case following successful surgical repair. Anatomic closure of the hole has been achieved.

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Macular hole prior to unsuccessful surgical repair.

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OCT appearance of the above case following failure to achieve anatomic hole closure.

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Epiretinal Membrane

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Epiretinal membranes cause varying amounts of visual loss and are visible as separate from the neurosensory retina.

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Posterior Vitreous Detachment

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The posterior hyaloid may separate from the surface of the retina. In this image, the posterior hyaloid was imaged approximately 250 microns anterior to the retina.

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