Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
| Autor: | Manoj Soman, Asmita Indurkar, Jay U. Sheth, Unnikrishnan Nair |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Visual acuity genetic structures Outer plexiform layer intraretinal cysts chemistry.chemical_compound Ophthalmology medicine Cyst External limiting membrane Macular hole Original Research Retina Retinal pigment epithelium en face imaging business.industry Retinal Clinical Ophthalmology medicine.disease eye diseases macular hole medicine.anatomical_structure chemistry spectral-domain optical coherence tomography sense organs medicine.symptom business |
| Zdroj: | Clinical Ophthalmology (Auckland, N.Z.) |
| ISSN: | 1177-5483 |
| Popis: | Unnikrishnan Nair,1,2 Jay U Sheth,1,2 Asmita Indurkar,1 Manoj Soman1,2 1Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India; 2Department of Research, Chaithanya Innovation in Technology and Eyecare (Research), Trivandrum, Kerala, IndiaCorrespondence: Jay U Sheth 32, Shiv-Mahal, Mathuradas Road, Kandivali (West), Mumbai, 400067, Maharashtra, IndiaTel +91 9961167200Email drjay009@gmail.comPurpose: To characterize retinal micromorphic changes on en face optical coherence tomography (OCT) and to determine their role in pathogenesis and visual outcomes in macular hole (MH) surgery.Patients and Methods: This is a retrospective, interventional, consecutive case series of 28 eyes undergoing successful MH surgery. Pre- and post-operative en face OCT were manually segmented, and the correlation between parameters such as MH basal diameter and minimal inlet area, area of cyst in inner plexiform layer (IPL) and outer plexiform layer (OPL), percentage of cyst in IPL and OPL, and amount of ellipsoid zone (EZ) defect and external limiting membrane (ELM) defect was performed. Their relationship with visual acuity (VA) outcomes (Group 1: ⥠20/60; 14 eyes; Group 2: < 20/60; 14 eyes) was also evaluated.Results: A significant positive correlation was noted between the cyst area in OPL and IPL (r=0.768; p< 0.001), which in turn were positively correlated with the basal diameter of the MH in all eyes. The cyst area was significantly more in IPL as compared to OPL in all eyes (p=0.049) and in group 2 (p=0.03) but not in group 1 (p=0.62). As compared to group 2, eyes in group 1 had significantly better pre- and post-operative VA, and significantly smaller basal diameter, minimal inlet area, area of cyst in IPL and OPL, and amount of defect in the ELM (postoperative) and EZ (pre- and post-operative), respectively.Conclusion: An increase in the basal diameter of the MH is associated with a simultaneous congruous enlargement of the area of cyst in IPL and OPL. Based on these imaging findings, we propose that the possible rationale for the origin of these intraretinal cysts could be a breakdown in the physiological retinal pigment epithelium (RPE) pump due to the anatomical separation of the neurosensory retina from the underlying RPE, ie, âRPE contact lossâ theory.Keywords: macular hole, spectral-domain optical coherence tomography, en face imaging, intraretinal cysts |
| Databáze: | OpenAIRE |
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