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S. Yokota, S. Ooto, M. Hangai, K. Takayama, S. Oshima, T. Inoue, N. Yoshimura; High-Resolution Imaging of Eyes With Closed Macular Holes by Using Adaptive Optics Scanning Laser Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1339.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the pathologic changes in the photoreceptors of eyes successfully treated for macular holes by using high-resolution images, which were obtained by adaptive optics scanning laser ophthalmoscopy (AO-SLO), and to compare the changes with visual acuity (VA) and the findings of spectral-domain optical coherence tomography (SD-OCT).
Fourteen eyes of 13 patients with idiopathic macular holes treated by vitrectomy and 20 normal eyes of volunteers were examined. All the patients underwent a complete ophthalmologic examination, SD-OCT, and imaging with an original prototype of the AO-SLO system fabricated using the liquid crystal-on-silicon technology.
All macular holes were successfully closed. In the case of normal eyes, AO-SLO images showed a regular photoreceptor mosaic pattern. In the case of eyes with closed macular holes, AO-SLO images revealed 2 distinct cone mosaic patterns. The eyes of group 1 had annular dark regions but an almost normal cone mosaic pattern in the foveal center. The eyes of group 2 had large dark regions that involved the foveal center, and showed significantly worse average logarithm of the minimum angle of resolution (logMAR) VA than those of group 1 (Mann-Whitney test; P = 0.013). In 10 eyes, the dark regions were seen on AO-SLO images in areas where SD-OCT images showed disruption in the inner and outer segment (IS/OS) junction of the photoreceptors; in 2 eyes, the dark regions were seen on AO-SLO images in areas where SD-OCT images showed an almost intact IS/OS junction.
AO-SLO images showed abnormal cone mosaic patterns in the fovea after the successful repair of macular holes. Deterioration of VA appeared to be associated with the involvement of the foveal center by the dark regions in cone mosaic, suggesting that AO-SLO is a useful modality to detect foveal photoreceptor abnormalities that are associated with the loss of VA.
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