Enhanced vitreous imaging optical coherence tomography in primary macular holes

Int Ophthalmol. 2016 Jun;36(3):355-63. doi: 10.1007/s10792-015-0126-y. Epub 2015 Sep 8.


The aim of the current pilot study is to investigate the efficacy of a novel enhanced vitreous imaging (EVI) in primary macular holes (MHs) using a spectral-domain optical coherence tomography (SD-OCT). Thirty-four eyes of 32 consecutive patients with a MH were examined in one time cross-sectional study. The vitreomacular interface was assessed using SD-OCT with conventional and EVI technique. Twenty-three of the 34 eyes did not show a Weiss ring, and in 22 of those, we observed a MH with an open roof or operculum and a detached posterior vitreous cortex with conventional vitreous imaging. Using EVI-OCT, we visualized the reflection of the posterior vitreous with a vitreopapillary attachment. One of the 23 eyes without a Weiss ring had a central round retinal defect without an operculum, and the conventional SD-OCT showed an empty vitreous, suggesting a complete posterior vitreous detachment. However, the EVI-OCT revealed the reflection of the posterior vitreous, and the cortex appeared to still be completely attached. In all the 23 eyes without a Weiss ring, EVI-OCT detected the reflection of the posterior vitreous and vitreopapillary attachment. In all 11 eyes with a Weiss ring (stage 4 hole), EVI-OCT showed an optically empty space in the posterior vitreous cavity without a vitreopapillary attachment. EVI-OCT may be a new reliable method for preoperative evaluations to determine the presence or absence of a complete posterior vitreous detachment in macular diseases with an indistinct Weiss ring.

Keywords: Enhanced vitreous imaging optical coherence tomography; Macular hole; Macular hole stage; Posterior vitreous detachment; Spectral-domain optical coherence tomography; Vitreomacular interface.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Retinal Perforations / diagnostic imaging
  • Retinal Perforations / pathology*
  • Tomography, Optical Coherence / methods*
  • Vitrectomy / methods
  • Vitreous Body / diagnostic imaging*
  • Vitreous Body / pathology
  • Vitreous Detachment / diagnostic imaging
  • Vitreous Detachment / pathology