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¹*Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin; †Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin; ‡Department of Biomedical Engineering, University of Rochester, Rochester, New York; §Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin; and ¶Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin.

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Summary

Even after successful macular hole surgery, photoreceptor disruption persists. However, the cone mosaic can remodel over many months, potentially explaining delayed visual acuity improvements after surgery.

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Area of Science:

Ophthalmology
Retinal Imaging
Cellular Biology

Background:

Macular hole (MH) closure is typically confirmed by optical coherence tomography.
The impact of MH surgery on photoreceptor structure and recovery is not fully understood.

Purpose of the Study:

To investigate photoreceptor structure and recovery following MH closure using pars plana vitrectomy (PPV).
To utilize adaptive optics scanning light ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SD-OCT) for detailed imaging.

Main Methods:

A pilot study involving four eyes from four patients undergoing PPV for MH.
Serial imaging using SD-OCT and AOSLO at various postoperative time points.

Main Results:

All patients showed disruption of the foveal inner segment ellipsoid zone post-PPV.
AOSLO revealed photoreceptor mosaic disruption correlating with ellipsoid zone defects seen on SD-OCT.
Cone cell recovery within disrupted areas was observed over time in serial imaging.

Conclusions:

Photoreceptor disruption is present after successful MH closure.
Foveal cone mosaic remodeling continues for months, potentially influencing visual acuity recovery.
SD-OCT and AOSLO are valuable for monitoring photoreceptor recovery after MH surgery.