Brief reportsPersistent outer retinal defect after successful macular hole repair
Section snippets
Case 1
A 59-year-old woman with a 6-week history of blurred vision OD presented with a stage 2 macular hole OD (Figure 1) and visual acuity of 20/70. She underwent pars plana vitrectomy, membrane peeling, and fluid-gas exchange. Postoperatively, her visual acuity improved to 20/25 at 7 weeks. The postoperative OCT studies demonstrated a persistent outer retinal defect at seven weeks. By 6 months, the defect resolved, and visual acuity improved to 20/20.
Case 2
A 62-year-old man with a 3-week history of visual loss OD presented with a stage 2 macular hole OD (Figure 2) and visual acuity of 20/60. He underwent pars plana vitrectomy, membrane peeling, and fluid–gas exchange. After 8 weeks, visual acuity improved to 20/20. Postoperative OCT analysis demonstrated a persistent outer retinal defect centrally, which diminished by 5 months despite still maintaining 20/20 visual acuity.
After successful macular hole repair, OCT demonstrates neurosensory retinal
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Cited by (42)
The Fovea: Structure, Function, Development, and Tractional Disorders
2021, The Fovea: Structure, Function, Development, and Tractional DisordersNew insights into the pathoanatomy of macular holes based on features of optical coherence tomography
2017, Survey of OphthalmologyAssessment of foveal microstructure and foveal lucencies using optical coherence tomography radial scans following macular hole surgery
2015, American Journal of OphthalmologyCitation Excerpt :The horizontal and vertical foveal lucency sizes at 12 months, for patients who did not undergo cataract surgery during the follow-up period, was 23.11 ± 41.4 μm and 16.72 ± 19.1 μm, respectively, compared to 27.6 ± 26.6 μm (P = .4) and 20.1 ± 18.3 μm (P = .4) in patients who had undergone cataract surgery. Foveal lucencies have been described following macular hole surgery by various terms such as foveal hyporeflective defects, foveal cysts, outer foveal defects, subfoveal fluid, persistent foveal detachment, persistent outer retinal defect, and a bridge-like glial proliferation.13–19 Various possible mechanisms have been suggested for these foveal lucencies, including a glial cell proliferative response, restoration of the outer segments from the intact photoreceptor body, regrowth of photoreceptor outer segments rather than a simple anatomic realignment of the photoreceptors, retinal pigment epithelial dysfunction, and potentially decreased mobility of the outer retina compared with the inner retina.13,18
Photoreceptor damage and foveal sensitivity in surgically closed macular holes: An adaptive optics scanning laser ophthalmoscopy study
2012, American Journal of OphthalmologyCitation Excerpt :To date, many studies using conventional time-domain OCT9,10,12,13,18,19 or SD OCT21–24 have reported a possible association between the integrity of the photoreceptor layer and visual improvement after successful MH repair. Several investigators have reported that a disrupted photoreceptor IS/OS junction,9,10,12,13,18,19,21–23 a disrupted ELM,24 or both may be associated closely with postoperative visual impairment. However, these studies could not ascertain how the individual photoreceptors are damaged after successful MH repair or how these damages are correlated with decreased visual function.
Incidence of outer foveal defect after macular hole surgery
2011, American Journal of Ophthalmology
Supported in part by Research to Prevent Blindness, Inc., New York, New York.