Residual defect in the foveal photoreceptor layer detected by optical coherence tomography in eyes with spontaneously closed macular holes.
OBJECTIVE
To assess the optical coherence tomography (OCT) characteristics of spontaneously closed macular hole (MH).


METHODS
Retrospective observational case series.


METHODS
Among 510 consecutive eyes examined for an MH before surgery, we retrospectively identified 14 eyes in which the MH closed spontaneously before the operation. At the time of diagnosis, Snellen visual acuity (VA) was measured and all 14 eyes underwent OCT1 or OCT3. The aperture and base diameters of the MHs were recorded. After spontaneous MH closure, VA was measured again and OCT3 was performed in all eyes. The photoreceptor (PR) inner segment-outer segment (IS-OS) junction line was examined to measure any residual defect at the foveal center.


RESULTS
Mean MH aperture diameter was small, less than 400 microm (mean +/- standard deviation [SD], 161.8 +/- 83.0 microm). After spontaneous closure, mean VA increased from 0.3 to 0.6. In all 14 eyes, foveal continuity was restored on OCT scans. However, a defect in the photoreceptor IS-OS junction layer ranging from 25 to 110 microm (mean +/- SD, 64.1 +/- 29.6 microm) was present in all eyes. No correlation was found, either between MH aperture diameter and the width of the PR defect (P = .68) or between VA and the width of the defect (P = .09).


CONCLUSIONS
In a series of 14 MHs that had closed spontaneously, a defect was seen in the photoreceptor IS-OS junction line, although VA improved in all eyes. When this configuration is seen in elderly patients without a history of MH, it may be taken as evidence of spontaneous closure of an undiagnosed MH.
Privat
Esther
E
Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique, Hôpitaux de Paris, Université Paris 7, Paris, France.
Tadayoni
Ramin
R
Gaucher
David
D
Haouchine
Belkacem
B
Massin
Pascale
P
Gaudric
Alain
A
D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D012075:Remission, Spontaneous; D012167:Retinal Perforations / Q000175:diagnosis*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity