title: Ultrahigh-resolution optical coherence tomography of surgically closed macular holes.
abstract: OBJECTIVE
  To evaluate retinal anatomy using ultrahigh-resolution optical coherence tomography (OCT) in eyes after successful surgical repair of full-thickness macular hole.
  
  
  METHODS
  Twenty-two eyes of 22 patients were diagnosed as having macular hole, underwent pars plana vitrectomy, and had flat/closed macular anatomy after surgery, as confirmed with biomicroscopic and OCT examination findings. An ultrahigh-resolution-OCT system developed for retinal imaging, with the capability to achieve approximately 3-microm axial resolution, was used to evaluate retinal anatomy after hole repair.
  
  
  RESULTS
  Despite successful closure of the macular hole, all 22 eyes had macular abnormalities on ultrahigh-resolution-OCT images after surgery. These abnormalities were separated into the following 5 categories: (1) outer foveal defects in 14 eyes (64%), (2) persistent foveal detachment in 4 (18%), (3) moderately reflective foveal lesions in 12 (55%), (4) epiretinal membranes in 14 (64%), and (5) nerve fiber layer defects in 3 (14%).
  
  
  CONCLUSIONS
  With improved visualization of fine retinal architectural features, ultrahigh-resolution OCT can visualize persistent retinal abnormalities despite anatomically successful macular hole surgery. Outer foveal hyporeflective disruptions of the junction between the inner and outer segments of the photoreceptors likely represent areas of foveal photoreceptor degeneration. Moderately reflective lesions likely represent glial cell proliferation at the site of hole reapproximation. Thin epiretinal membranes do not seem to decrease visual acuity and may play a role in reestablishing foveal anatomy after surgery.
authors.affiliation: Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Mass, USA.
authors.forename: Tony H
authors.initials: TH
authors.lastname: Ko
authors.forename: Andre J
authors.initials: AJ
authors.lastname: Witkin
authors.forename: James G
authors.initials: JG
authors.lastname: Fujimoto
authors.forename: Annie
authors.initials: A
authors.lastname: Chan
authors.forename: Adam H
authors.initials: AH
authors.lastname: Rogers
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Baumal
authors.forename: Joel S
authors.initials: JS
authors.lastname: Schuman
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Drexler
authors.forename: Elias
authors.initials: E
authors.lastname: Reichel
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
mesh_terms: D000368:Aged; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012167:Retinal Perforations / Q000175:diagnosis* / Q000601:surgery*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014821:Vitrectomy