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PubMed2006

Clinical application of rapid serial fourier-domain optical coherence tomography for macular imaging.

PURPOSE: To introduce and examine the utility of a retinal imaging technique using high-speed optical coherence tomography (OCT) for creating a more complete retinal structural map to aid in the evaluation of patients with macular pathology. DESIGN: Prospective observational case series. PARTICIPANTS: Five patients with a variety of macular pathologies. METHODS: Patients were imaged with a Fourier-domain high-speed high-resolution OCT system built at our institution. A sweeping serial OCT B-scan of the macula was acquired to create a detailed retinal structural map. The data were then used to make individual clinical observations. RESULTS: Rapid serial OCT B-scans produced detailed macular maps for all 5 patients. Diagnoses of imaged patients included macular hole, lamellar macular hole, regressed macular hole or macular microhole, choroidal neovascular membrane (CNV) from age-related macular degeneration, and CNV from presumed ocular histoplasmosis syndrome. Reconstructed B-scans and C-scans are shown for selected patients to illustrate the additional perspectives gained by obtaining a detailed retinal map. CONCLUSIONS: Rapid serial Fourier-domain OCT B-scanning can be used to create a detailed retinal structural map. This technique provides additional information that can be missed on single OCT images and provides an accurate way to image large or complex lesions, and allows B-scan and C-scan reconstructions to be made that provide additional perspectives into retinal structures that may be missed using traditional imaging methods.

Adult↗
PubMed2006

Outcomes of vitrectomy with inferior retinectomy in patients with recurrent rhegmatogenous retinal detachments and proliferative vitreoretinopathy.

PURPOSE: To report the anatomic and functional outcomes of patients treated with vitrectomy and inferior retinectomy for recurrent, rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (PVR). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Fifty-six patients with recurrent, rhegmatogenous retinal detachments complicated by PVR who underwent an inferior retinectomy for repair. METHODS: Retrospective review over a 6-year period of patients treated with vitrectomy and inferior retinectomy. MAIN OUTCOME MEASURES: The primary outcome was anatomic success, defined as complete retinal reattachment. Secondary outcomes included change in visual acuity, the mean number of operations required for complete retinal reattachment, number of operations before retinectomy, use of silicone oil tamponade, location and extent of retinectomy, whether lensectomy was undertaken, and incidence of postoperative complications. RESULTS: Complete retinal reattachment was achieved in 52 of 56 patients (93%), with a mean follow-up of 25 months (range, 6-70 months). After retinal reattachment, visual acuity was improved or stabilized in 39 of 56 patients (70%). The mean number of operations for retinal detachment before diagnosis of PVR requiring retinectomy was 1.8 (range, 1-5). Patients undergoing radical anterior vitreous base dissection and lensectomy at the time of first retinectomy had a higher success rate than those who did not: 74% versus 38%, respectively (P = 0.011). Furthermore, tamponade with silicone oil had a higher success rate than tamponade with gas: 71% versus 18%, respectively (P = 0.002). Of the 56 patients, 9 (16%) had 1 or more of the following complications: keratopathy requiring penetrating keratoplasty (n = 4), glaucoma requiring aqueous shunt device (n = 3), and hypotony (n = 3). Silicone oil removal was performed in 26 of 45 patients (58%) before the last follow-up visit, with a 1 in 26 (4%) redetachment rate. CONCLUSIONS: When combined with anterior base dissection, inferior retinectomy may be useful in the surgical treatment of complex PVR-related retinal detachment. The authors show that with lensectomy, radical anterior base dissection, and inferior retinectomy, anatomic success rates are improved and visual function can be maintained. In addition, silicone oil offers an advantage over gas tamponade in these cases.

Aged↗
PubMed2006

Identification of retinal breaks using subretinal trypan blue injection.

PURPOSE: To describe the use of subretinal trypan blue to identify retinal breaks during vitrectomy for rhegmatogenous retinal detachment (RD). DESIGN: Interventional case series. PARTICIPANTS: Five patients with RD in whom no retinal break could be identified by internal search with scleral indentation. METHODS: Trypan blue 0.15% was injected transretinally into the subretinal space using a 41-gauge cannula designed for macular translocation surgery. Perfluorocarbon heavy liquid was then injected into the vitreous cavity and the eye was rotated such that trypan blue was vented out of the break. The plume of trypan blue was used to identify retinal breaks, or in some cases staining of the break facilitated break detection. Subretinal fluid was then drained through the break or a drainage retinotomy and surgery was completed using standard techniques. MAIN OUTCOME MEASURE: Identification of previously unseen retinal breaks. RESULTS: This technique successfully identified a retinal break in 4 out of 5 patients. After absorption of the gas tamponade all retinas remained attached with a median visual acuity of 6/12. CONCLUSION: Failure to identify a retinal break during RD surgery is a well-recognized clinical challenge that may adversely affect outcome. In this setting, chromophore-assisted retinal break detection may be a useful surgical technique.

Adolescent↗
PubMed2007

Spontaneous reattachment of rhegmatogenous retinal detachment.

PURPOSE: To describe the clinical characteristics of spontaneous reattachment of rhegmatogenous retinal detachment (SRRRD). DESIGN: Retrospective observational case series. PARTICIPANTS: Fifteen patients who were diagnosed with SRRRD. METHODS: The medical records of 15 patients were reviewed. Spontaneous reattachment of rhegmatogenous retinal detachment was confirmed via serial observation in 4 of the eyes, and the remaining eyes represented patients in whom the condition was presumed to develop. MAIN OUTCOME MEASURES: Clinical features and association. RESULTS: This study involved 6 male patients and 9 female patients with a mean age of 48.0 years. The mean refractive errors in the involved and contralateral eyes were -5.0 and -5.3 diopters, respectively. All 15 eyes evidenced diffuse retinal pigmentary alterations within a sharply demarcated and convex margin. The lesions were located in the inferior retina in 10 of the 15 eyes, limited to 6 clock hours or fewer (66.7%). Although subretinal gliotic bands were detected within the lesion in 11 patients (73.3%), epiretinal proliferation was evident in only 2 patients (13.3%). Retinal changes associated with rhegmatogenous retinal detachment were noted in the fellow eyes of 7 patients (46.7%). CONCLUSIONS: Spontaneous reattachment of rhegmatogenous retinal detachment should be included in differential diagnoses of patients with diffuse retinal pigmentary alterations within a sharply demarcated convex margin in unilateral eyes. Small retinal breaks observed in nonvitrectomized eyes may be associated with the occurrence of SRRRD.

Adult↗
PubMed2006

Treatment of stage 2 macular hole by intravitreous injection of expansile gas and induction of posterior vitreous detachment.

PURPOSE: To demonstrate the morphological and functional outcomes of intravitreous injection of an expansile gas bubble for the treatment of stage 2 macular holes. DESIGN: Prospective interventional case series. PARTICIPANTS: Twenty eyes of 20 consecutive patients with unilateral stage 2 macular holes. METHODS: The patients underwent intravitreous sulfur hexafluoride injection, followed by postoperative facedown positioning for 3 to 5 days. The patients were observed per protocol schedule with complete ophthalmological examination, including determination of corrected visual acuity (VA), slit-lamp biomicroscopic examination, funduscopic examination, and optical coherence tomography (OCT). Follow-up was greater than 12 months for all patients (mean, 19.5). MAIN OUTCOME MEASURES: Posterior vitreous detachment, anatomical closure of the hole, VA, and hole diameter as measured by OCT. RESULTS: Detachment of the posterior vitreous at the macula was achieved in 19 of 20 eyes (95%). Ten cases (50%) had anatomical closure of the hole with intravitreous gas injection alone. The remaining 10 cases (50%) achieved anatomical closure of the hole after subsequent vitreous surgery. There was a significant difference in hole diameter (P = 0.004) and in pretreatment vision (P = 4.5x10(-5)) in patients for whom gas alone resulted in hole closure and those proceeding to vitreous surgery. Hole closure by gas injection alone was achieved in 7 of 7 eyes (100%) with pretreatment vision better than 20/40 and in 6 of 7 eyes (86%) when the hole was smaller than 200 mum. There were no major complications in this series of patients. Successfully treated macular holes remained closed at all follow-up points during the study period. CONCLUSION: An intravitreous injection of an expansile concentration of the inert sulfur hexafluoride gas alone frequently induces detachment of the posterior vitreous in the aged eye. Anatomical closure of the hole without major complications is more likely in smaller holes with better pretreatment vision. This technique may have clinical application for stage 2 holes in selected cases. A number of potential advantages including decreased morbidity and a potential cost savings may result from successful utilization of this procedure.

Aged↗
PubMed2006

Pars plana vitrectomy, laser retinopexy, and aqueous tamponade for pseudophakic rhegmatogenous retinal detachment.

OBJECTIVE: To evaluate a novel pars plana vitrectomy (PPV) approach with aqueous tamponade for repair of primary pseudophakic rhegmatogenous retinal detachment (RRD). DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Sixty nonconsecutive patients (60 eyes) with primary pseudophakic RRD. INTERVENTION: Patients underwent PPV alone with injection of perfluoro-n-octane followed by fluid-air exchange and transscleral diode laser retinopexy and then balanced salt solution (BSS) tamponade. All patients were observed for at least 1 year. MAIN OUTCOME MEASURES: Anatomic outcome, visual acuity (VA), and complications. RESULTS: The mean follow-up period was 16.4 months (range, 12.1-21.5). Preoperatively, 32 patients (53.3%) had 1 break and 28 patients (46.7%) had 2 to 4 breaks (mean, 2.7). Intraoperatively, 108 retinal breaks were identified, 82 (75.9%) superior and 26 (24%) inferior. Eight breaks in 8 patients that were not seen preoperatively or intraoperatively were diagnosed after air-BSS exchange. Mean preoperative best-corrected VA (BCVA) was 20/700 (range, hand movements [HM]-20/20). Final BCVA was a mean of 20/59 (range, 20/200-20/20). For the 13 eyes with macula-attached RRD, BCVA was the same preoperatively and postoperatively (mean, 20/27; range, 20/50-20/20). For the 47 eyes with macula-detached RRD, the mean BCVA was 20/888 preoperatively (range, HM-20/50) and 20/68 postoperatively (range, 20/200-20/20). Final VA was > or =20/40 in 34 of 60 eyes (56.6%). Primary retinal reattachment (attachment at 1 month postoperatively) was attained in 59 of the 60 patients (98.3%). The single failure was due to a new break postoperatively; this break was treated by pneumatic retinopexy and photocoagulation of the break. At the 12-month follow-up visit, reattachment had been attained in all 60 eyes (100%). Postoperatively, 1 patient (1.6%) had hypotony at the 1-day postoperative visit, but intraocular pressure was 14 mm at the 4-day visit, and 2 patients (3.3%) had mild vitreous hemorrhage during the first 48 hours that resolved spontaneously during the following 10 days. CONCLUSION: Pars plana vitrectomy with laser retinopexy followed by BSS tamponade is effective for intraoperative sealing of retinal breaks causing pseudophakic RRD. We did not identify safety concerns in this 60-patient series.

Acetates↗
PubMed2006

Effect of indocyanine green staining in peeling of internal limiting membrane for retinal detachment resulting from macular hole in myopic eyes.

PURPOSE: To investigate the effect of using indocyanine green (ICG) to stain the internal limiting membrane (ILM) during vitrectomy in eyes with retinal detachment resulting from macular hole (MHRD). DESIGN: Nonrandomized comparative trial. PARTICIPANTS: Thirty-two cases of MHRD. INTERVENTION: The medical records of the cases were reviewed retrospectively. During the initial vitrectomy, the ILM was peeled in 22 eyes with ICG (group A) and in 10 eyes without ICG (group B). MAIN OUTCOME MEASURES: Anatomic reattachment, visual acuity, and optical coherence tomography-determined macular hole closure were measured. RESULTS: The initial reattachment rate in group A (86%) was significantly higher than in group B (40%; P = 0.013, Fisher exact test). The postoperative visual acuity at 6 months and the visual improvements at 6 and 12 months in eyes with an initial reattachment were not significantly different between the 2 groups (P = 0.123, Mann-Whitney rank-sum test; P = 0.17, t test; P = 0.237, t test). The postoperative visual acuity at 12 months with an initial reattachment in group A was significantly better than in group B (P = 0.039, t test). The macular hole closure rate with an initial reattachment was 6 of 17 eyes (35%) in group A and 0 of 4 eyes (0%) in group B, and this difference was not significant (P = 0.281, Fisher exact test). CONCLUSIONS: These results show that ICG staining improves the initial reattachment rate and is associated with better postoperative visual acuity at 12 months. Therefore, ICG staining should be used during vitrectomy for MHRD because the complete removal of the ILM with ICG ensures the removal of the tangential traction by an epiretinal membrane and the inverse traction by the retina that cannot follow the posterior enlargement of a staphyloma.

Aged↗
PubMed2006

Three-dimensional imaging of macular holes with high-speed optical coherence tomography.

OBJECTIVE: To demonstrate the advantages of 3-dimensional imaging of macular hole pathology using new-generation high-speed optical coherence tomography (OCT). DESIGN: Prospective observational case series. PARTICIPANTS: Twenty-one eyes from 20 consecutive patients diagnosed with a macular hole. METHODS: A prototype high-speed OCT system was built based on a Fourier-domain OCT (FD OCT) technology for patient examination. The system has achieved sensitivity of approximately 98 decibels, axial resolution of approximately 4.3 mum in tissue, and an acquisition rate of approximately 18,700 axial scans per second. Three-dimensional imaging of macular hole pathology was performed based on a raster scan protocol consisting of 256x256 axial scans. All patients were imaged with 3-dimensional OCT, Stratus OCT, and OCT Ophthalmoscope C7. MAIN OUTCOME MEASURES: Images of macular hole pathologies obtained by 3-dimensional OCT and standard OCT instruments. RESULTS: The 3-dimensional OCT imaging successfully generated realistic 3-dimensional images of the vitreofoveal interface and intraretinal microstructures associated with a macular hole. The 3-dimensional overview of the vitreofoveal interface was helpful in gaining an immediate understanding of the dynamic interactions of the vitreous and fovea. Observations of consecutive en face images in combination with conventional longitudinal images and of cross-sectional images in combination with sectioned volume images enabled identification of intraretinal microstructures and their 3-dimensional extension associated with a macular hole, such as subfoveal structural changes after vitreous traction, connection of the flap to intraretinal structures, the external limiting membrane (ELM) and its disruption, and elevated photoreceptor inner and outer segments delineated by the ELM. The appearance of inner-wall images of a macular hole produced by photoreceptor inner and outer segment backreflection varied throughout macular hole stages. CONCLUSIONS: Three-dimensional imaging of macular holes with high-speed OCT based on FD OCT technology offers 3-dimensional overviews that facilitate understanding of the abnormalities in the vitreofoveal interface. It also provides consecutive orthogonal images that allow much more precise and minute observation of 3-dimensionally extending intraretinal structural changes associated with a macular hole than conventional OCT imaging, especially in the photoreceptor inner and outer segments.

Aged↗
PubMed2006

Macular hole: perceptual filling-in across central scotomas.

The present study examined perceptual distortions of a vertical line before and after macular hole (MH) surgery in 25 eyes of 24 patients. Participants' perceptual reports of distortions were classified as solid, bent right/left, thinned at the center, or broken. The majority of patients (72%) reported symmetrical distortions of the line pre-operatively. After surgery, participants with larger MHs were more likely to retain residual distortions. Of particular interest is the group reporting thinning of the line preoperatively, as the center should be perceptually missing. Examination of MH diameters in relation to the line perceptions indicated that the shape of the perceived line can be explained at the retinal level, while its continuity must be perceptually created at the cortical level.

Adult↗
PubMed2000

Internal limiting membrane removal in the management of full-thickness macular holes.

PURPOSE: To determine the effectiveness of removal of the internal limiting membrane in the treatment of full-thickness macular holes. METHODS: Data were reviewed from a prospective study on 47 consecutive eyes with full-thickness macular holes undergoing vitrectomy, internal limiting membrane maculorhexis, and fluid-gas exchange. No eye underwent repeat macular hole surgery. A meta-analysis was performed to compare the outcomes of different surgical techniques in the treatment of full-thickness macular holes. RESULTS: The outcome measures were disappearance of the submacular fluid and the change in best-corrected visual acuity. The surgery was anatomically successful in 44 of the 46 eyes (96%) and 39 of the eyes (85%) showed an improvement of at least two Snellen lines. Best-corrected final vision was 20/40 in 18 (39%) eyes. No permanent complications specifically caused by the removal of the macular internal limiting membrane were detected; the minor hemorrhages and retinal edema seen in most eyes resolved spontaneously. Retinal detachment developed and was successfully treated in three eyes (7%). A meta-analysis on 1,654 eyes from published reports showed that internal limiting membrane maculorhexis appears to significantly (P <.0001) increase the anatomical and functional success rates in macular hole surgery. CONCLUSIONS: Internal limiting membrane removal is an important development in the evolving field of macular hole surgery. A randomized, prospective, multicenter clinical trial should be performed to determine which surgical technique is the most beneficial in patients with full-thickness macular holes.

Adolescent↗
PubMed2000

Hepatocyte growth factor levels in the vitreous of patients with proliferative vitreoretinopathy.

PURPOSE: To determine whether the hepatocyte growth factor is increased in the vitreous of patients with proliferative vitreoretinopathy. METHODS: We assayed hepatocyte growth factor levels by enzyme-linked immunosorbent assay (ELISA) in vitreous samples from 65 consecutive eyes (65 patients) with proliferative vitreoretinopathy (23 eyes), rhegmatogenous retinal detachment (22 eyes), and macular hole or idiopathic epiretinal membrane (control subjects, 20 eyes) having undergone pars plana vitrectomy. RESULTS: Vitreous levels of hepatocyte growth factor were 3.94 +/- 2.29 (mean +/- SD) ng/ml in proliferative vitreoretinopathy, 2.02 +/- 0.84 ng/ml in rhegmatogenous retinal detachment, and 2.16 +/- 1.39 ng/ml in the control subjects. The vitreous levels in proliferative vitreoretinopathy were much greater than levels in rhegmatogenous retinal detachment (P =.0002) and in the control subjects (P =.0007). In proliferative vitreoretinopathy, there was a tendency toward higher levels in eyes with grade D by the Retina Society terminology. CONCLUSION: The results suggest the possibility that hepatocyte growth factor may play a role in the pathogenesis of proliferative vitreoretinopathy.

Enzyme-Linked Immunosorbent Assay↗
PubMed2000

Three-dimensional observations of developing macular holes.

PURPOSE: To describe the morphologic features of idiopathic macular holes and vitreous traction during macular hole evolution. METHODS: We prospectively examined 89 eyes of 82 patients with idiopathic macular holes (stage 1, 15 eyes; stage 2, 16 eyes; stage 3, 50 eyes; stage 4, eight eyes) using optical coherence tomography. In addition to optical coherence tomography, scanning laser ophthalmoscopy was performed in all 15 eyes with stage 1 hole, six of 16 eyes with stage 2, and 19 of 50 eyes with stage 3. RESULTS: In stage 1 eyes, optical coherence tomography revealed retinal split or cystic changes at the fovea in 11 of 15 eyes (73%) and foveal retinal detachment in four eyes (27%). Two eyes with foveal cysts progressed to stage 2, and one developed a stage 3 hole. In one eye with retinal detachment, the detached retina thinned and developed dehiscence. Optical coherence tomography showed a vitreous cortex that was detached in the perifoveal area but attached on the fovea in 11 of the 15 stage 1 eyes. In stage 2 macular holes, retinal tissue extending from the perifoveal retina formed a flap. Scanning laser ophthalmoscopy demonstrated intraretinal radiating striae, which corresponded to a foveal cyst or perifoveal cystic changes. CONCLUSIONS: Macular holes start as retinal splits or foveal cysts in most cases. The anterior wall of the cyst serves as a flap in stage 2 and an operculum in stage 3 holes. Radiating striae correspond to retinal splits or cysts and presumably represent an elevation of Henle fiber. In a few macular holes, foveal detachment is the initial change. The detached retina thins and eventually develops a hole. In both courses, anterior traction of the slightly detached vitreous cortex appears to be a major contributing factor to macular hole formation.

Aged↗
PubMed2000

Rhegmatogenous retinal detachment in retinoblastoma patients undergoing chemoreduction and cryotherapy.

PURPOSE: To report the development of rhegmatogenous retinal detachment, with the retinal break adjacent to a cryotherapy scar, in three patients undergoing systemic chemotherapy for intraocular retinoblastoma. METHOD: Case series. RESULTS: Three patients with intraocular retinoblastoma were referred after poor response to systemic chemotherapy and local cryotherapy; three eyes of these three patients were noted to have rhegmatogenous retinal detachment and active retinoblastoma, with retinal breaks adjacent to cryotherapy scars. CONCLUSION: Rhegmatogenous retinal detachment may result from retinal necrosis associated with cryotherapy in the setting of intraocular retinoblastoma treated with systemic chemotherapy and local cryotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Tomographic features of early macular hole closure after vitreous surgery.

PURPOSE: To report the optical coherence tomographic features of macular hole closure in the first months after vitreous surgery. METHODS: We studied prospectively the tomographic features of 28 eyes (28 patients) with idiopathic macular holes before and after vitreous surgery by optical coherence tomography. We compared the best-corrected visual acuity levels with the postoperative tomographic features. RESULTS: The 25 eyes with successfully sealed macular holes had one of two tomographic features within 1 month postoperatively: simple closure (normal foveal configuration) in 14 eyes (56%) or a bridge formation at the fovea that mimicked a foveal retinal detachment in 11 eyes (44%). It took an average of 2.0 months (range, 0.8 to 3.5 months) for the bridge tissue to attach to the retinal pigment epithelium. Best-corrected visual acuity quickly improved in the former group; visual improvement began 1 month after attachment of the bridge tissue in the latter group. A closed hole reopened 4 months postoperatively in one eye with a bridge formation. CONCLUSIONS: Idiopathic macular holes have one of two patterns early after surgical closure, simple closure or a bridge formation. Visual improvement starts after the fovea assumes a normal configuration. The bridge formation appears to reflect an early phase and fragile condition in the anatomic closure of macular holes.

Aged↗
PubMed2000

Outcomes of macular hole surgery in severely myopic eyes: a case-control study.

PURPOSE: To evaluate the outcomes of macular hole surgery in highly myopic eyes and to compare these outcomes with a control group of eyes that were not severely myopic. METHODS: The study design was a matched, case-control, retrospective chart review. The participants included 26 eyes of 24 patients who had vitreous surgery for macular holes. The eyes were divided into two groups: 13 consecutive eyes with severe myopia (defined as -6.00 diopters of refractive error or greater) and 13 control eyes without severe myopia that were operated on immediately before or after each study eye, with the most recently operated eye chosen. The main outcome parameters were preoperative and final follow-up visual acuity, macular hole closure rates, reoperation rates, duration of preoperative symptoms, and follow-up time. RESULTS: Using the Snellen equivalent of logarithm of minimal angle of resolution (logMAR) units, visual acuity improved after macular hole surgery in severely myopic eyes from 20/152 to 20/89 (P =.041) and in control eyes from 20/152 to 20/47 (P <.001). At final follow-up, visual acuities were lower in severely myopic eyes compared with control eyes (P =.048). Macular hole closure rates, reoperation rates, duration of pre-operative symptoms, and follow-up intervals were not significantly different statistically between groups. CONCLUSIONS: Macular hole surgery results in anatomical and visual improvements in severely myopic eyes but generally yields poorer visual acuity outcomes compared with eyes that are not severely myopic.

Adult↗
PubMed2000

Amsler grid examination and optical coherence tomography of a macular hole caused by accidental Nd:YAG laser injury.

PURPOSE: To compare a macular hole from accidental Nd:YAG laser injury with idiopathic macular holes. METHODS: Case report. In a 24-year-old man with accidental Nd:YAG laser injury, right eye, Amsler grid testing and optical coherence tomography were performed. RESULTS: Nd:YAG laser injury was responsible for a macular hole about 700 microm in diameter. The visual acuity was 20/100. Amsler grid testing displayed a central scotoma with no surrounding distortion. Optical coherence tomography showed a defect in all retinal layers at the macula. CONCLUSION: The scotoma caused by Nd:YAG laser injury is not surrounded by distortion; the hole is produced by the defect of all retinal layers. In contrast, idiopathic macular holes generally produce a pincushion pattern on Amsler grid testing and have no tissue loss.

Accidents, Occupational↗
PubMed2000

Optical coherence tomograghy to confirm early closure of macular holes.

PURPOSE: To report that optical coherence tomography as early as 24 hours after macular hole surgery shows anatomic configuration of the closed macular holes. METHOD: In a prospective study, seven eyes of seven consecutive patients with stage 3 or 4 idiopathic macular hole underwent surgery. Optical coherence tomography was performed preoperatively and at 24, 48, and 72 hours after the surgery. RESULTS: Optical coherence tomography images could be obtained on four out of the seven eyes at 24 hours after surgery. These images showed anatomic configuration of the closed macular holes. Surgical success was confirmed in all of the eyes when the gas was completely absorbed. CONCLUSION: Optical coherence tomography revealed anatomic configuration of surgically closed macular holes within 24 hours after successful surgery.

Aged↗