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S. V. Luccarelli, F. Bottoni, A. Giani, G. Staurenghi; Post-Surgical Tissue Reparation of Full Thickness Macular Holes: A Spectral-Domain Optical Coherence Tomography Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3259.
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To evaluate the process of retinal repair using Spectral-Domain OCT (HRA Spectralis, Heidelberg Engineering) in eyes with successfully operated full thickness macular holes (FTMH).
Ten eyes with FTMH underwent standard pars plana vitrectomy (complete vitreous removal, ICG 0.07% assisted ILM peeling and SF6 20% gas tamponade) and were followed up for at least six months.Retinal anatomy was analyzed with SD-OCT at 1, 3 and 6 months after hole repair. Each follow-up scan was performed exactly at the same location by means of the dedicated software of the HRA Spectralis. OCT findings were analyzed by expert retinal specialists in order to determine the different features of the healing process of the macular hole.
All the 10 eyes were successfully closed after a single operation. All of them displayed macular abnormalities on SD-OCT images. These abnormalities were separated into the following 3 categories: 1. hyporeflective defects of photoreceptor inner/outer segment junction, 2. hyporeflective defects of the external limiting membrane, 3. presence of moderately reflective foveal lesion. Hyporeflective defects of photoreceptor inner/outer segment junction was found in 10 patients (100%) at 1 month and at 3 months, in 2 patient (20%) at 6 months; external limiting membrane defects was observed in 8 patients (80%) at 1 month, in 5 patients (50%) at 3 months and in 2 patient (20%) at 6 months. Moderately reflective foveal lesion was found in 5 patients (50%) at 1 month and at 3 months and in 4 patients (40%) at 6 months. A partial reabsorption of the moderately reflective foveal lesion was observed in 2 patients. After at least 3 Months of follow-up. Visual acuity was correlated with the progressive normalization of the IS/OS junction and external limiting membrane.
SD-OCT shows new features in the follow up of the foveal structure after successful surgical closure of FTMH. In particular, the juxtaposition of the external limiting membrane and subsequently of the IS/OS junction seems to drive the healing process. The presence of a moderately reflective foveal lesion is likely to be correlated to glial elements which may disappear at the completion of the healing process. The clinical significance of these findings remains to be validated in larger series.
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