title: Objective assessment of foveal cone loss ratio in surgically closed macular holes using adaptive optics scanning laser ophthalmoscopy.
abstract: OBJECTIVE
  To use adaptive optics scanning laser ophthalmoscopy (AO-SLO) to quantify cone loss ratio in the foveola in order to assess foveal cone status and to investigate relationships between foveal structural abnormalities and visual function in patients with macular hole (MH) after surgery.
  
  
  METHODS
  We evaluated 10 normal eyes of 10 healthy volunteers and 19 eyes of 18 patients in whom anatomically successful MH closure had been performed. All subjects underwent a comprehensive ophthalmologic examination that included measurements of spectral-domain optical coherence tomography and AO-SLO.
  
  
  RESULTS
  On AO-SLO regular cone mosaic was seen in all normal eyes whereas dark regions suggesting cone loss were seen in all eyes after MH repair. Visual acuity was better in eyes without dark regions at the center of the fovea than in eyes with them (P = 0.001). Cone loss ratio in the foveola correlated with postoperative visual acuity (P<0.001), mean foveal sensitivity (P = 0.029), thinner inner and outer segments at the center of the fovea (P = 0.002), larger size of the disrupted inner and outer segment junction line (P = 0.018), and cone outer segment tip line (P<0.001). Cone loss ratio in the foveola was significantly greater in eyes that had moderately reflective foveal lesions after surgery (P = 0.006).
  
  
  CONCLUSIONS
  AO-SLO is a useful means of assessing foveal cone damage objectively and quantitatively. The location and extent of cone damage, especially if it involves the foveola, is an important factor determining visual function after MH surgery.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yokota
authors.forename: Sotaro
authors.initials: S
authors.lastname: Ooto
authors.forename: Masanori
authors.initials: M
authors.lastname: Hangai
authors.forename: Kohei
authors.initials: K
authors.lastname: Takayama
authors.forename: Naoko
authors.initials: N
authors.lastname: Ueda-Arakawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshihara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hanebuchi
authors.forename: Nagahisa
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods; D017949:Retinal Cone Photoreceptor Cells / Q000473:pathology*; D012167:Retinal Perforations / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D014792:Visual Acuity