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Retina. 2011 Jan;31(1):127-47. doi: 10.1097/IAE.0b013e3181e7997b.

Stage 1-A macular hole: a prospective spectral-domain optical coherence tomography study.

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Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.



To determine the anatomical morphology of Stage 1-A impending macular holes characterized by a yellow spot using spectral-domain optical coherence tomography to study the fellow eyes of patients diagnosed with a full-thickness macular hole or eyes with a typical yellow spot with metamorphopsia.


Prospective observational case series of 45 patients with a full-thickness macular hole or a foveolar yellow spot with metamorphopsia. Visual acuity assessment, biomicroscopic examination, and spectral-domain optical coherence tomography were performed. Clinical ophthalmologic examinations were repeated, including spectral-domain optical coherence tomography, in the eyes with a foveolar yellow spot at 1-month interval.


We examined 43 fellow eyes of 43 patients with a macular hole and 2 eyes of 2 patients with a foveolar yellow spot. Five fellow eyes had a yellow spot. Spectral-domain optical coherence tomography clearly showed the reflectivity of the perifoveal posterior vitreous detachment with vitreofoveal adhesion in the 7 eyes with a yellow spot; the foveal microstructure had a triangular foveolar detachment of the cone outer segment tip line, of which only 2 eyes (29%) had foveal splits during the observational period, 3 eyes (43%) had a foveal perpendicular line, and 4 eyes (57%) showed progression to vitreofoveal separation before the development of inner splits or pseudocysts. In those 7 eyes, the 2 eyes (29%) with foveal splits progressed to a full-thickness macular hole. The 38 fellow eyes without a yellow spot had no foveolar detachment.


The foveolar detachment of the cone outer segment tip line might be responsible for the yellow spot seen in Stage 1-A macular holes.

[Indexed for MEDLINE]

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