title: Residual defect in the foveal photoreceptor layer detected by optical coherence tomography in eyes with spontaneously closed macular holes.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique, Hôpitaux de Paris, Université Paris 7, Paris, France.
authors.forename: Esther
authors.initials: E
authors.lastname: Privat
authors.forename: Ramin
authors.initials: R
authors.lastname: Tadayoni
authors.forename: David
authors.initials: D
authors.lastname: Gaucher
authors.forename: Belkacem
authors.initials: B
authors.lastname: Haouchine
authors.forename: Pascale
authors.initials: P
authors.lastname: Massin
authors.forename: Alain
authors.initials: A
authors.lastname: Gaudric
mesh_terms: 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