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Invest Ophthalmol Vis Sci 2013;54: E-Abstract 2839.
© 2013 ARVO


Assessing Photoreceptor Structure Following Macular Hole Closure

Sean Batson1, Sean Hansen1, Peter Karth1, Robert Cooper1, Drew Scoles1, David Weinberg1, Alfredo Dubra1, Judy Kim1, Joseph Carroll1 and William Wirostko1

1 Ophthalmology, Medical College of Wisconsin, Milwaukee, WI

Commercial Relationships: Sean Batson, None; Sean Hansen, None; Peter Karth, None; Robert Cooper, None; Drew Scoles, None; David Weinberg, Regeneron (F); Alfredo Dubra, US Patent No: 8,226,236 (P); Judy Kim, None; Joseph Carroll, Imagine Eyes, Inc. (S); William Wirostko, None

Support: None


Purpose:To assess foveal photoreceptor structure in eyes that have undergone vitrectomy surgery for closure of macular holes (MH) using spectral-domain optical coherence tomography (SD-OCT) and adaptive optics scanning light ophthalmoscopy (AOSLO).

Methods:In a prospective case series, 7 eyes of 7 patients were imaged with SD-OCT on an average 4.5 months (range, 2-6) after undergoing pars plana vitrectomy, internal limiting membrane peeling, and gas injection for closure of idiopathic MH. A subset of 4 eyes also underwent simultaneous imaging with AO-SLO, with one of these eyes imaged a second time 12 months after surgery.

Results:Abnormalities of the ellipsoid portion of the inner segment (ISe) band can be seen near the fovea with SD-OCT, including focal disruption, attenuation, and diffuse mottling. Areas of ISe abnormalities correspond to hyporeflective areas observed on AOSLO. Areas of hyporeflective mosaic disruption can be as small as 100 microns, and may decrease in size between 3 months and 12 months after surgery without "shifting" of the cone mosaic (see Figure 1). Hyper-reflective external limiting membrane structures were also seen with SD-OCT and AOSLO overlying focal ISe lesions.

Conclusions:Abnormalities of the ISe can be seen with SD-OCT following surgical closure of MH. These changes correspond with hyporeflective areas of cone mosaic disruption on AOSLO. Areas of hyporeflective cone mosaic disruption on AOSLO may decrease in size over time. SD-OCT and AOSLO imaging may be a useful modality to detect and monitor recovery of photoreceptor structure in eyes undergoing surgical closure of MH.

Figure 01
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Fig. 1


Keywords: 586 macular holes • 550 imaging/image analysis: clinical • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)

© 2013, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.