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Reorganization of photoreceptor layer on optical coherence tomography concurrent with visual improvement after macular hole surgery.

Lee JE, Lee SU, Jea SY, Choi HY, Oum BS - Korean J Ophthalmol (2008)

Bottom Line: The photoreceptor layer had been reorganized and visual acuity had improved to 20/25 by 1 year.Visual acuity improved to 20/50 by four months.Visual acuity had improved further to 20/40 by 1 year, concurrent with improved organization of the photoreceptor layer.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea. jlee@pusan.ac.kr

ABSTRACT
To report three cases in which reorganization of the photoreceptor layer on optical coherence tomography (OCT) was concurrent with long-term visual recovery after macular hole surgery. Serial OCT scans of three eyes in which visual acuity continued to improve for 1 or more years after successful macular hole surgery were reviewed. Case 1. At postoperative four weeks, visual acuity was 20/100 with disorganized photoreceptor layer on OCT. The photoreceptor layer had been reorganized and visual acuity had improved to 20/25 by 1 year. Case 2. Two weeks after the operation, visual acuity was 20/125 and disorganization of the photoreceptor layer was noted. Visual acuity improved to 20/50 by four months. The photoreceptor layer had been partly reorganized and had appearance of a broken line. Visual acuity had improved to 20/40 and the photoreceptor layer had been reorganized further with a residual defect on OCT by 15 months. Case 3. Visual acuity at two weeks was 20/100. OCT revealed disorganization of the photoreceptor layer. Six months after the operation, the partly reorganized photoreceptor layer appeared as a broken line and visual acuity had reached 20/80. Visual acuity had improved further to 20/40 by 1 year, concurrent with improved organization of the photoreceptor layer. The reorganization of the photoreceptor layer plays a part in long-term improvement of visual acuity after macular hole surgery.

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Case 1. Serial horizontal optical coherence tomography (OCT) scans after successful macular hole surgery. (A) Preoperative OCT image shows a full-thickness macular hole with a pseudo-operculum. (B and C) Pseudocolor-coded and enhanced images at 4 weeks show disorganization 1820 µm wide (arrow heads) in the photoreceptor layer. Visual acuity was 20/100. (D and E) OCT images at 6 month reveal reorganization of the photoreceptor layer (arrows). The area of disorganization had decreased and visual acuity had improved to 20/40. (F and G) By 1 year, visual acuity had improved to 20/25, concurrent with further reorganization of the photoreceptor layer (arrows). The changes of the photoreceptor layers can be identified more clearly on the enhanced images (C, E and G) than with the conventional images (B, D and F). (H, I, and J) Video images taken simultaneous with the OCT scans show the identical location of the scans.
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Figure 1: Case 1. Serial horizontal optical coherence tomography (OCT) scans after successful macular hole surgery. (A) Preoperative OCT image shows a full-thickness macular hole with a pseudo-operculum. (B and C) Pseudocolor-coded and enhanced images at 4 weeks show disorganization 1820 µm wide (arrow heads) in the photoreceptor layer. Visual acuity was 20/100. (D and E) OCT images at 6 month reveal reorganization of the photoreceptor layer (arrows). The area of disorganization had decreased and visual acuity had improved to 20/40. (F and G) By 1 year, visual acuity had improved to 20/25, concurrent with further reorganization of the photoreceptor layer (arrows). The changes of the photoreceptor layers can be identified more clearly on the enhanced images (C, E and G) than with the conventional images (B, D and F). (H, I, and J) Video images taken simultaneous with the OCT scans show the identical location of the scans.

Mentions: A 67-year-old woman who had complained of decreased vision of the left eye for one month was diagnosed with a stage 3 macular hole (Fig. 1A) and had visual acuity of 20/80. She underwent pars plana vitrectomy, triamcinolone acetonide-assisted internal limiting membrane (ILM) peeling and fluid-gas exchange.


Reorganization of photoreceptor layer on optical coherence tomography concurrent with visual improvement after macular hole surgery.

Lee JE, Lee SU, Jea SY, Choi HY, Oum BS - Korean J Ophthalmol (2008)

Case 1. Serial horizontal optical coherence tomography (OCT) scans after successful macular hole surgery. (A) Preoperative OCT image shows a full-thickness macular hole with a pseudo-operculum. (B and C) Pseudocolor-coded and enhanced images at 4 weeks show disorganization 1820 µm wide (arrow heads) in the photoreceptor layer. Visual acuity was 20/100. (D and E) OCT images at 6 month reveal reorganization of the photoreceptor layer (arrows). The area of disorganization had decreased and visual acuity had improved to 20/40. (F and G) By 1 year, visual acuity had improved to 20/25, concurrent with further reorganization of the photoreceptor layer (arrows). The changes of the photoreceptor layers can be identified more clearly on the enhanced images (C, E and G) than with the conventional images (B, D and F). (H, I, and J) Video images taken simultaneous with the OCT scans show the identical location of the scans.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629936&req=5

Figure 1: Case 1. Serial horizontal optical coherence tomography (OCT) scans after successful macular hole surgery. (A) Preoperative OCT image shows a full-thickness macular hole with a pseudo-operculum. (B and C) Pseudocolor-coded and enhanced images at 4 weeks show disorganization 1820 µm wide (arrow heads) in the photoreceptor layer. Visual acuity was 20/100. (D and E) OCT images at 6 month reveal reorganization of the photoreceptor layer (arrows). The area of disorganization had decreased and visual acuity had improved to 20/40. (F and G) By 1 year, visual acuity had improved to 20/25, concurrent with further reorganization of the photoreceptor layer (arrows). The changes of the photoreceptor layers can be identified more clearly on the enhanced images (C, E and G) than with the conventional images (B, D and F). (H, I, and J) Video images taken simultaneous with the OCT scans show the identical location of the scans.
Mentions: A 67-year-old woman who had complained of decreased vision of the left eye for one month was diagnosed with a stage 3 macular hole (Fig. 1A) and had visual acuity of 20/80. She underwent pars plana vitrectomy, triamcinolone acetonide-assisted internal limiting membrane (ILM) peeling and fluid-gas exchange.

Bottom Line: The photoreceptor layer had been reorganized and visual acuity had improved to 20/25 by 1 year.Visual acuity improved to 20/50 by four months.Visual acuity had improved further to 20/40 by 1 year, concurrent with improved organization of the photoreceptor layer.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea. jlee@pusan.ac.kr

ABSTRACT
To report three cases in which reorganization of the photoreceptor layer on optical coherence tomography (OCT) was concurrent with long-term visual recovery after macular hole surgery. Serial OCT scans of three eyes in which visual acuity continued to improve for 1 or more years after successful macular hole surgery were reviewed. Case 1. At postoperative four weeks, visual acuity was 20/100 with disorganized photoreceptor layer on OCT. The photoreceptor layer had been reorganized and visual acuity had improved to 20/25 by 1 year. Case 2. Two weeks after the operation, visual acuity was 20/125 and disorganization of the photoreceptor layer was noted. Visual acuity improved to 20/50 by four months. The photoreceptor layer had been partly reorganized and had appearance of a broken line. Visual acuity had improved to 20/40 and the photoreceptor layer had been reorganized further with a residual defect on OCT by 15 months. Case 3. Visual acuity at two weeks was 20/100. OCT revealed disorganization of the photoreceptor layer. Six months after the operation, the partly reorganized photoreceptor layer appeared as a broken line and visual acuity had reached 20/80. Visual acuity had improved further to 20/40 by 1 year, concurrent with improved organization of the photoreceptor layer. The reorganization of the photoreceptor layer plays a part in long-term improvement of visual acuity after macular hole surgery.

Show MeSH
Related in: MedlinePlus