Hyperreflective Stress Lines and Macular Holes.

Area of Science:

• Ophthalmology
• Retinal Imaging
• Macular Diseases

Background:

• Full-thickness macular holes (FTMH) and lamellar macular holes (LMH) are significant retinal conditions affecting central vision.
• Optical coherence tomography (OCT) is crucial for diagnosing and monitoring macular pathologies.
• Identifying early indicators of FTMH development is essential for timely intervention.

Purpose of the Study:

• To determine the prevalence of a central vertical hyperreflective line in eyes with FTMH and LMH.
• To elucidate the pathoanatomic significance of this OCT finding.

Main Methods:

• Retrospective analysis of spectral-domain OCT (SD-OCT) scans from patients with FTMH and LMH.
• Evaluation of three cohorts: pre-FTMH development, post-pars plana vitrectomy (PPVT) for FTMH, and LMH.
• Analysis of central vertical hyperreflective line presence on SD-OCT volume scans.

Main Results:

• A central vertical hyperreflective line was observed in 50% of eyes preceding FTMH development.
• The line was present in 51% of resolved FTMH cases post-PPVT.
• Twenty-five percent of LMH eyes displayed the hyperreflective line.

Conclusions:

• The central vertical hyperreflective line may serve as an early SD-OCT marker for FTMH development.
• This finding could indicate central foveal dehiscence due to Muller cell cone disruption.
• The hyperreflective line is a notable sign in both FTMH and LMH eyes.