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Photoreceptor damage and foveal sensitivity in surgically closed macular holes: an adaptive optics scanning laser ophthalmoscopy study.
Am J Ophthalmol. 2012 Jul; 154(1):174-186.e2.AJ

Abstract

PURPOSE

To assess photoreceptor structure using adaptive optics scanning laser ophthalmoscopy (AO SLO) and spectral-domain optical coherence tomography (SD OCT) and to evaluate the relationship between structural abnormalities and foveal sensitivity in eyes with surgically closed macular hole (MH).

DESIGN

Prospective, interventional case series.

METHODS

Twenty-one eyes of 19 patients with idiopathic MH underwent a full ophthalmologic examination, including SD OCT at baseline. Imaging with SD OCT, an original prototype AO SLO system, and microperimetry were performed at 6 months after surgery.

RESULTS

All patients underwent anatomically successful MH closure. On AO SLO, dark areas (0.004 to 0.754 mm(2)) were seen in all eyes after MH repair. Lower cone density correlated with poorer postoperative visual acuity and lower mean foveal sensitivity (both P < .001). Larger dark areas on AO SLO correlated with poorer postoperative visual acuity (P = .003) and lower mean foveal sensitivity (P = .006). Cone density was significantly lower and dark areas were significantly larger in eyes that had defects of the outer segments in the fluid cuff before surgery (P = .018 and P = .001, respectively) and moderately reflective foveal lesions after surgery (P < .001 and P < .001, respectively). Larger dark areas correlated with longer symptom duration before surgery (P < .001).

CONCLUSIONS

Structural damage to the photoreceptor layer correlated with greater decreases in visual function in eyes with surgically closed MH. AO SLO imaging is a useful and quantitative tool for detecting photoreceptor abnormalities and their association with visual acuity and retinal sensitivity in eyes with closed MH.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. ohoto@kuhp.kyoto-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22534108

Citation

Ooto, Sotaro, et al. "Photoreceptor Damage and Foveal Sensitivity in Surgically Closed Macular Holes: an Adaptive Optics Scanning Laser Ophthalmoscopy Study." American Journal of Ophthalmology, vol. 154, no. 1, 2012, pp. 174-186.e2.
Ooto S, Hangai M, Takayama K, et al. Photoreceptor damage and foveal sensitivity in surgically closed macular holes: an adaptive optics scanning laser ophthalmoscopy study. Am J Ophthalmol. 2012;154(1):174-186.e2.
Ooto, S., Hangai, M., Takayama, K., Ueda-Arakawa, N., Hanebuchi, M., & Yoshimura, N. (2012). Photoreceptor damage and foveal sensitivity in surgically closed macular holes: an adaptive optics scanning laser ophthalmoscopy study. American Journal of Ophthalmology, 154(1), 174-e2. https://doi.org/10.1016/j.ajo.2012.01.031
Ooto S, et al. Photoreceptor Damage and Foveal Sensitivity in Surgically Closed Macular Holes: an Adaptive Optics Scanning Laser Ophthalmoscopy Study. Am J Ophthalmol. 2012;154(1):174-186.e2. PubMed PMID: 22534108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Photoreceptor damage and foveal sensitivity in surgically closed macular holes: an adaptive optics scanning laser ophthalmoscopy study. AU - Ooto,Sotaro, AU - Hangai,Masanori, AU - Takayama,Kohei, AU - Ueda-Arakawa,Naoko, AU - Hanebuchi,Masaaki, AU - Yoshimura,Nagahisa, Y1 - 2012/04/24/ PY - 2011/11/09/received PY - 2012/01/31/revised PY - 2012/01/31/accepted PY - 2012/4/27/entrez PY - 2012/4/27/pubmed PY - 2012/8/30/medline SP - 174 EP - 186.e2 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 154 IS - 1 N2 - PURPOSE: To assess photoreceptor structure using adaptive optics scanning laser ophthalmoscopy (AO SLO) and spectral-domain optical coherence tomography (SD OCT) and to evaluate the relationship between structural abnormalities and foveal sensitivity in eyes with surgically closed macular hole (MH). DESIGN: Prospective, interventional case series. METHODS: Twenty-one eyes of 19 patients with idiopathic MH underwent a full ophthalmologic examination, including SD OCT at baseline. Imaging with SD OCT, an original prototype AO SLO system, and microperimetry were performed at 6 months after surgery. RESULTS: All patients underwent anatomically successful MH closure. On AO SLO, dark areas (0.004 to 0.754 mm(2)) were seen in all eyes after MH repair. Lower cone density correlated with poorer postoperative visual acuity and lower mean foveal sensitivity (both P < .001). Larger dark areas on AO SLO correlated with poorer postoperative visual acuity (P = .003) and lower mean foveal sensitivity (P = .006). Cone density was significantly lower and dark areas were significantly larger in eyes that had defects of the outer segments in the fluid cuff before surgery (P = .018 and P = .001, respectively) and moderately reflective foveal lesions after surgery (P < .001 and P < .001, respectively). Larger dark areas correlated with longer symptom duration before surgery (P < .001). CONCLUSIONS: Structural damage to the photoreceptor layer correlated with greater decreases in visual function in eyes with surgically closed MH. AO SLO imaging is a useful and quantitative tool for detecting photoreceptor abnormalities and their association with visual acuity and retinal sensitivity in eyes with closed MH. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/22534108/Photoreceptor_damage_and_foveal_sensitivity_in_surgically_closed_macular_holes:_an_adaptive_optics_scanning_laser_ophthalmoscopy_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(12)00082-7 DB - PRIME DP - Unbound Medicine ER -