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M. Hangai, Y. Ojima, A. Tsujikawa, A. Otani, M. Kita, N. Yoshimura; Preoperative En face Imaging of the Outer Photoreceptor Layer in Macular Holes by Using Fourier Domain Optical Coherence Tomography is Associated With Visual Outcome After Successful Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):140.
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We have reported that en face images reconstructed from three-dimensional Fourier domain optical coherence tomography (FD-OCT) enable visualization of the doughnut-shaped outer photoreceptor layer (DOPL) in macular holes. The purpose of this study was to determine whether preoperative FD-OCT imaging of DOPL is correlated with early postoperative visual acuity (VA).
Using a prototype high-speed OCT system based on FD-OCT technology, 22 eyes of 22 patients who had undergone successful macular hole surgery at Kyoto University Hospital from December 2005 to October 2006 were examined. The system has a sensitivity of 98 dB, tissue axial resolution of 4.3 µm, and an acquisition rate of ~18,700 axial scans per second. The data set for 3D imaging was acquired based on a raster scan comprising 256 × 256 axial scans within a 2.8 × 2.8 mm square. For observation, volume rendering was performed and en face images were reconstructed using Amira 3.1.
High-quality en face images were obtained before surgery for 18 eyes; the images were adequate for determining whether the DOPL was complete or defective. Macular hole closure was achieved in all 18 eyes. Nine eyes showed complete DOPL, whereas the other 9 showed defective DOPL. In the complete DOPL group, the mean age was 65.9 ± 7.1 years (range, 49-73 years), and the mean follow-up duration was 5.0 ± 1.7 months (range, 3-7 months). In the defective DOPL group, the mean age was 60.6 ± 7.4 years (range, 52-77 years), and the mean follow-up duration was 5.9 ± 2.0 months (range, 4-9 months). No statistical significance in the age or follow-up duration was observed between the groups. The mean final logarithm of the minimum angle of resolution (logMAR) VA was 0.096 ± 0.11 (range, 0-0.3) in the complete DOPL group vs. 0.60 ± 0.37 (range, 0-1.3) in the defective DOPL group (p = 0.002).
The DOPL defects observed in the en face images were significantly correlated with poor postoperative VA. Thus, en face imaging of the DOPL may be used to predict the visual outcome of surgically closed macular holes.
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