A patient with suspected macular hole undergoes OCT imaging. The scan shows a full-thickness defect in the fovea with a cuff of subretinal fluid and no vitreofoveal traction. According to the Gass classification, this corresponds to which stage of macular hole?

• A Stage 1a (foveal detachment)
• B Stage 2 (small full-thickness hole <400 micrometers)
• C Stage 3 (full-thickness hole with fluid cuff, no PVD) ✓
• D Stage 4 (full-thickness hole with complete PVD)

Explanation

Stage 3 macular hole is defined as a full-thickness foveal defect with a surrounding cuff of subretinal fluid, an overlying operculum, and no posterior vitreous detachment. Stage 2 is a small hole without a fluid cuff. Stage 4 has a complete PVD. Stage 1a shows foveal pseudocyst without a true hole.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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