Abstract
Purpose :
To evaluate the correlations between morphologic and functional photoreceptor changes in patients macular hole closure types studied with adaptive optics(AO) combined with spectral-domain OCT (SD-OCT), OCT angiography (OCTA) and microperimetry (MPM) .
Methods :
This prospective, observational study included 31 eyes of 28 patients who underwent surgery for MH for 1w to 2 years . Pre- best-corrected visual acuity (BCVA),retinal anatomic lesions and diameter of MH on SD-OCT were collected. OCTA, OCT,BCVA and retinal mean sensitivity (RMS) at 8°, 68.2%BCEA, and fovea 2°and 4° fixation rate (P1 and P2) on MPM, and images of photoreceptor and cone density captured on AO were performed post surgery. The patients were divided into two closure types on basis of postoperative OCT. Type 1 showed as flat retinal edges with no defect of neurosensory retina on the fovea, and type 2 with a defect .
Results :
There were 16 eyes ended with type 1 macular hole closure, and 15 with type 2 MH closure. Consistent with the integrity of IS/OS layer on OCT, more photoreceptor were observed shifting to fovea on AO in type 1 closure. However, more large and high-density cells and less photoreceptor were shown type 2 closure, which were suspected as glia cells and fiber proliferation showing as high-refectivity on OCT. More over, compared to the OCTA enface images, clear edge of MH were obtained on AO. Functionally, higher RMS, fixation rate and lower 68.2%BCEA and better postoperative BCVA were tested in type 1 MH closure patients, compared to type 2. Additionally, Type 1 MH closure was correlated with better preoperative VA, small MH size and less lesions of the outer retinal layers (P < 0.05).
Conclusions :
Adaptive optics combined with OCT can detect the nature of macular hole closure. Postoperative outer retinal layer integrity is associated with photoreceptor shifting to macular, indicating better final retinal sensitivity and BCVA.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.