Comparison of ultrasonographic examinations with surgical findings after surgery of idiopathic macular hole

PURPOSE: In retrospective study to compare echographic features of posterior vitreous face and vitreo-macular region with preoperative findings by pars plana vitrectomy of idiopathic macular hole. MATERIAL AND METHOD: The group includes 27 eyes with idiopathic macular hole. 11 in II. and 16 in III. stage by Gass's classification. The spectrum of identifiable echographic features included: 1. partial posterior vitreous face separation; 2. presence of a pseudooperculum; 3. high spike of posterior vitreous face over the macula and/or optic nerve head and 4. combination of these findings, eventually some other pathology of vitreous. Peroperative clinical findings included: 1. presence of a pseudooperculum; 2. facility of elevation and separation of posterior vitreous face. RESULTS: The echographic findings showed: 1. 5-times (18.5%) partial posterior vitreous face separation; 2. 5-times (18.5%) the presence of a pseudooperculum; 3. 4-times (14.8%) the high spike of posterior vitreous face in front of the retinal surface spike; 4. 10-times (37.0%) the combination of 1. -3. and/or some other pathology of vitreous. 3 eyes (11.2%) were without relevant pathologic echographic findings. Preoperatively was 1. the presence of a pseudooperculum confirmed in 9 eyes (33.3%). 6-times (22.2%) the posterior vitreous face had separated by core vitrectomy, no active elevation was needed. In 21 eyes (77.8%) the active elevation of posterior vitreous face was performed, 6-times (28.4%) was the elevation more difficult. CONCLUSION: Echographic features of posterior vitreous face and vitreomacular region correlate with preoperative findings by pars plana vitrectomy and determine a strategy of surgical intervention.