* From the Retina Service and Retina Founda tion, Department of Ophthalmology of the Massa chusetts Eye and Ear Infirmary and Harvard Medi cal School. (Paper 18, Retina Foundation and Retina Service.) This work was supported by the Insti tute of Neurological Diseases and Blindness, of the National Institutes of Health, Department of Health, Education, and Welfare (Grant No. BS6R and No. BS6C), by the Vivian B. Allen Founda tion, and by the American Optical Company. t Schepens, C. L. : Clinical aspects of pathologic changes in the vitreous body. Am. J. Ophth., 38 : 1-21 (July, Part II) 1954. When first examined, macular edema was no ticed but, a few weeks later, a true macular tear surrounded by flat retinal detachment was observed. In Figure la, the tear is somewhat irregu lar, about half the size of the disc, and an operculum is present on its temporal side, casting a shadow on the detached retina. Examination with the slitlamp and flat contact lens reveals the presence of a fine membrane located in the vitreous cavity, in front of the disc and macula (fig. l b ) . This picture is obtained by focusing the slitlamp microscope on the membrane and then sweeping the joy-stick* laterally. An annular thickening of the membrane surrounds a hole which corresponds to the area of the disc. Temporally, the annular thickening is continuous with a dense band, at the end of which another annular thicken ing is visible. The latter surrounds a smaller hole, which is located in front of the macula. When an optical section is carefully ex amined (fig. lc) , it is apparent that, posterior to the limiting membrane, the vitreous cav-
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Jun 25, 2019
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