title: Disruption of the photoreceptor inner segment-outer segment junction in eyes with macular holes.
abstract: OBJECTIVE
  To examine the relationship between visual acuity and morphologic characteristics of macular holes as determined using spectral domain optical coherence tomography (SD OCT).
  
  
  METHODS
  A retrospective analysis was performed of eyes with open and closed macular holes at a single, referral-based retina practice. The main outcome measures included best-corrected Snellen visual acuity and SD OCT findings, including the size of the macular hole and the disruption of the junction between inner segments (ISs) and outer segments (OSs) of the photoreceptors.
  
  
  RESULTS
  The mean visual acuity for eyes with open (n = 24) and closed (n = 17) macular holes was 20/166 (range, 5/400 to 20/40) and 20/39 (range, 20/80 to 20/25), respectively. The mean macular hole diameter was 859 microm. A disruption of the IS-OS junction was observed in all eyes, and this disruption had a mean diameter of 1,947 microm in eyes with an open macular hole and 626 microm in those with a closed macular hole. There was a negative correlation between both the size of the macular hole (P < 0.001) and the IS-OS disruption (P = 0.01) and visual acuity in eyes with open macular holes. In eyes with closed macular hole, the size of the IS-OS disruption was not correlated with visual acuity (P = 0.82).
  
  
  CONCLUSIONS
  The photoreceptor layer appears to be involved for a much larger area than that occupied by the macular hole itself. The abnormality in the IS-OS boundary line may reflect perturbation of a higher level of retinal organization and not an absolute loss of photoreceptor OSs.
authors.affiliation: Vitreous, Retina, Macula Consultants of New York, and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA.
authors.forename: Louis K
authors.initials: LK
authors.lastname: Chang
authors.forename: Hideki
authors.initials: H
authors.lastname: Koizumi
authors.forename: Richard F
authors.initials: RF
authors.lastname: Spaide
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D012167:Retinal Perforations / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D012374:Rod Cell Outer Segment / Q000473:pathology*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D013459:Sulfur Hexafluoride