Photo Credit: umgh
The following is a summary of “Comparison of the photoreceptor mosaic before and after macular hole surgery with high resolution adaptive optics imaging,” published in the October 2024 issue of Ophthalmology by Oquendo et al.
Researchers conducted a retrospective study to investigate the photoreceptor mosaic in patients with idiopathic full-thickness macular hole (MH) before and after pars plana vitrectomy (PPV) with adaptive optics-enhanced retinal imaging (AO).
They examined patients with MH treated with PPV at the Kensington Eye Institute in Toronto, Canada. Patients with secondary MH, high myopia, media opacity, or previous intraocular surgery were excluded; AO fundus camera imaging was performed preoperatively and 3 months postoperatively. Cone density (CD), regularity, dispersion, and spacing were measured at 2° and 4° eccentricity in 4 quadrants (superior, inferior, nasal, and temporal) while comparing the pre-and postoperative values.
The results showed a significant decrease in CD and increased spacing and dispersion at 2° postoperatively, while regularity remained unchanged. At 2° , pre-and postoperative CD was 14612 ± 3003 and 12280 ± 4632 photoreceptors/mm 2 [95%CIs= -2413 to -702] (P =0.0004), regularity was 88 ± 7% and 84 ± 12% [95%CIs= -4.67 to 0.04] (P =0.054), dispersion was 19 ± 6% and 23 ± 10% [95%CIs= 0.5 to 4.24] (P =0.013), and spacing was 9 ± 1 microns and 10 ± 2 microns [95%CIs= 0.40 to 1.27] (P =0.0002). At 4° , 13377 ± 4339 and 12770 ± 4391 photoreceptors/mm2 [95%CIs= -1368 to 252] P=0.176, regularity:87 ± 9% and 86 ± 12% [95%CIs= -4.65 to 0.08] P =0.74, dispersion: 20 ± 8% and 20 ±9 % [95%CIs= -2.11 to 1.5] p=0.74, spacing:10 ± 2 microns and 10 ± 3 microns [95%CIs= -0.23 to 0.58] P =0.39 were not significant.
They concluded that adaptive optics imaging effectively quantified changes in the photoreceptor mosaic at 2° pre- and post-PPV in individuals with MH, enabling detailed evaluation of photoreceptor remodeling and surgical outcomes.