Improved visualization of macular hole lesions with laser biomicroscopy
Y. Ogura, M. Shahidi, M. T. Mori, N. P. Blair and R. Zeimer
Department of Ophthalmology, UIC Eye Center, University of Illinois, Chicago College of Medicine 60612.
We have developed instrumentation to improve the visualization of fine
vitreoretinal structures at the macula during slit-lamp biomicroscopy. The
instrument, mounted on a slit-lamp microscope, used a green helium-neon
laser to deliver a narrow beam, 15 micron(s) in width and 2 mm in length.
The intersection of the laser slit with the ocular structures was viewed at
an angle, as in conventional slit-lamp biomicroscopy. The instrument was
used to examine patients with idiopathic macular holes or cysts. The
results indicated that the new illumination was superior due to the narrow
width of the beam, the enhanced brightness, and the monochromacy in green,
which reduced background scatter. These advantages allowed for
visualization of fine retinal structures that are difficult to detect with
conventional slit-lamp biomicroscopy. The findings in patients with
idiopathic macular hole demonstrated that the operculum was located
approximately 500 micron(s) anterior to the surrounding retina and moved
minimally. This suggested that the operculum may be supported by partially
detached posterior vitreous cortex, and that a macular hole is the result
of tangential traction followed by axial traction caused by a contracted
and detached cortical vitreous gel.
