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Logo of brjopthalBritish Journal of OphthalmologyCurrent TOCInstructions for authors
 
Br J Ophthalmol. 1997 February; 81(2): 117–122.
PMCID: PMC1722103
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Differentiating full thickness macular holes from impending macular holes and macular pseudoholes
M. Tsujikawa, M. Ohji, T. Fujikado, Y. Saito, M. Motokura, I. Ishimoto, and Y. Tano
Department of Ophthalmology, Osaka University Medical School, Japan.
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Abstract
AIMS—The reliability of scanning laser ophthalmoscope (SLO) microperimetry in differentiating full thickness macular holes from macular pseudoholes and impending macular holes was evaluated.
METHODS—106 eyes with the clinical diagnosis of full thickness macular holes, macular pseudoholes, and impending (stage 1) macular holes were examined for the presence of deep or relative scotoma using SLO microperimetry. The relation between these scotomas and the clinical diagnosis was studied.
RESULTS—Deep and relative scotomas were detected in all 57 eyes with clinically defined full thickness macular holes. In contrast, among 49 eyes diagnosed with macular pseudoholes or impending macular holes, no deep and only one relative scotoma was observed. The sensitivity of the presence of a deep scotoma as an indicator of the clinical diagnosis of a full thickness macular hole was 100% (57 of 57), and the specificity was 100% (49 of 49). The sensitivity of the presence of a relative scotoma was 100% (57 of 57) and the specificity was 98.0% (48 of 49).
CONCLUSION—With SLO microperimetry, full thickness macular holes can be precisely and objectively distinguished from other conditions that mimic macular holes.

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Figure 1
Figure 1  
(A) Fundus photograph of a patient with a full thickness macular hole. (B) Scanning laser ophthalmoscope microperimetry with a 0 dB stimulus from the same patient. The white `A's indicate points seen by the patient, and black `A's correspond (more ...)
Figure 2
Figure 2  
(A) Fundus photograph of a patient with a macular pseudohole. (B) Scanning laser ophthalmoscope microperimetry with a 10 dB stimulus from the same patient. A relative scotoma was not detected.
Figure 3
Figure 3  
Fundus photograph and scanning laser ophthalmoscope (SLO) microperimetry of case 1. A 50-year-old woman presented with a 5 day history of visual loss in her right eye. The initial diagnosis was an impending macular hole. (A) Fundus photograph (more ...)
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