Abstract

Outer lamellar macular holes (OLMH) are very rare compared to inner lamellar macular holes. An OLMH can occur associated with optic pit maculopathy, in the progression of myopic macular retinoschisis, transient in the development of full thickness macular holes or idiopathic. This article reports on infrared imaging of OLMHs. Infrared (IR) images in 2 patients aged 22 and 34 years with OLMH were taken using IR reflection at a wavelength of 820 nm with a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2, Heidelberg Engineering). IR images were correlated with linear optical coherence tomography (OCT) scans (Stratus-OCT, Zeiss). Images were acquired during follow-up of up to 30 months and if applicable preoperatively and postoperatively. Clear infrared signals were recorded especially in OLMH associated with optic pit maculopathy. Correlation with linear OCT scans showed the enhanced infrared signals to be restricted to the extent of the OLMH. The borders of the OLMH could be clearly delineated. Infrared imaging enables a top view of OLMH and therefore allows an excellent documentation of the course of OLMH. Infrared reflection is useful for two-dimensional imaging of OLMH. Infrared imaging can provide a supplement to slice imaging for OCT diagnostics and allows monitoring of OLMH over time. The postoperative sequence of OLMH closure in patients with optic pit maculopathy can be studied in more detail using infrared imaging.

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