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Yonguk Kim, Hyung-Woo Kwak, Seung-Young Yu; En Face Spectral-Domain Optical Coherence Tomography Imaging of Photoreceptor Layer in Repaired Macular Hole. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4253.
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To evaluate en face spectral-domain optical coherence tomography (SD-OCT) findings of photoreceptor layer in patients with surgically repaired macular holes (MHs).
We retrospectively studied 112 eyes with anatomically closed idiopathic full-thickness MHs following pars plana vitrectomy. The SD-OCT scans were obtained using the Macular Cube 512 x 128 scan of the Cirrus HD-OCT (Carl Zeiss, Dublin, CA, USA). The scanned data were processed using embedded tools of advanced visualization. A partial thickness OCT fundus images of the ellipsoid zone (EZ) was generated by setting the region of interest to a 20-µm thick layer, which was parallel and adjacent to the retinal pigment epithelium. Baseline hyperreflective mottling (HRM) area of MH in en face EZ slab was analyzed by ImageJ software (version 1.46, National Institutes of Health, Bethesda, MD). Foveal homogeneity of en face EZ slab and best-corrected visual acuity (BCVA) were followed for 12 months. Visual outcome was evaluated on the basis of multivariate analyses with proportional hazards models to account for correlation between baseline HRM and disruption of foveal homogeneity.
Mean baseline visual acuity (logMAR) was 0.88±0.35 and baseline HRM of EZ slab was observed in 45 (40.2%) eyes. Disruption of foveal homogeneity of EZ slab at month 12 was observed in 39 of 45 (86.7%) eyes with baseline HRM and was correlated with vision gain and visual acuity at month 12 (R=-0.411, p=0.005; R=0.496, p=0.001, respectively). Eyes with baseline HRM (adjusted hazard ratio [aHR], 7.93; 95% confidence interval [CI], 2.61-18.98) had higher incidence of disruptive foveal homogeneity at month 12. Vision gain (logMAR) at month 12 was greater in eyes without baseline HRM than in eyes with HRM (0.42±0.26, 0.20±0.34, respectively, p<0.001). Among the 45 eyes with baseline HRM, the mean HRM area (pixels) of EZ slabs was 1367.7±903.0. Baseline HRM area was correlated with vision gain and visual acuity at month 12 (R=-0.485, p=0.001; R=0.550, p<0.001, respectively). Eyes with greater baseline HRM area (aHR, 1.97; 95% CI, 1.91-4.64) had lower visual acuity at month 12.
Baseline HRM of MHs in en face EZ slab significantly correlated with visual acuity and disruption of foveal microstructure following surgery. Preoperative HRM in en face EZ slab may be indicative of poor visual outcome in repaired MHs.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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