Three-dimensional characteristics of macular pseudoholes using confocal laser tomography.
BACKGROUND: Epiretinal membranes with macular pseudoholes are sometimes confused with full-thickness macular holes. Because both the natural course and clinical management of the two differ, an accurate differential diagnosis is needed. PATIENTS AND METHODS: We obtained three-dimensional images of macular pseudoholes in 12 eyes using the Heidelberg retina tomograph (HRT). Another 15 eyes with a full-thickness macular hole were also studied. In addition, we measured the area and the maximum depth of both types of holes. RESULTS: Irregular rippling undulations were frequently observed on the three-dimensional topographic maps around the pseudoholes, whereas elevated cuffs were observed around the full-thickness holes. The maximum depth of the macular pseudoholes (mean, 57 microm) was significantly shallower than that of the full-thickness macular holes (mean, 156 microm; P < 0.01). CONCLUSION: Three-dimensional images obtained by the HRT and the measurement of the maximum depth may be useful in differentiating macular pseudoholes from full-thickness macular holes.