Macular Diseases

Color photograph of the right fundus demonstrates a pseudohole. Intraretinal cystic changes caused by the vitreoretinal traction become apparent in the red-free image. OCT scan demonstrates the incomplete vitreous separation with vitreous attachment to the perifoveal retina.

Incomplete vitreous separation with persistent vitreous attachment to the macula May also lead to the formation of epiretinal membrane, macular puckering, cystoid macular edema with or without fluorescein leakage, tractional macular detachment and frank macular hole Spontaneous resolution has been reported Clinical features: Symptoms: May be asymptomatic Decreased vision Metamorphopsia in the presence of macular pucker Signs: Dull foveal reflex Wrinkling of the retina Stretching or corrugating appearance of the retinal vessels Pseudohole Management: Observation if symptoms have been stable Vitrectomy with membrane peeling in patients with worsening vision of less than 20/50 and significant metamorphopsia

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