Full-Thickness Macular Hole Formation after Internal Limiting Membrane Peeling: Beware the “Omega Sign”

Figure 1

(a) Infrared reference image and (b) foveal spectral domain optical coherence tomography (SDOCT) raster scan of the right macula. (c) Subretinal hemorrhage displaced outer retinal tissue laterally to produce an “omega-” shaped contour for the outer retina superimposed as yellow on same SDOCT raster scan. (d) Foveal SDOCT raster scan after PPV with subretinal tissue plasminogen activator and ILM peeling that included the fovea, which had resulted postoperatively in macular hole with serous and rhegmatogenous retinal detachment that failed to clear spontaneously. (e) Foveal SDOCT raster scan five months postoperatively demonstrates persistent macular hole and temporal sealed retinotomy with underlying subretinal hyperreflective material and transmission due to retinal atrophy.

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