title: Inner segment ellipsoid band and cone outer segment tips changes preceding macular hole development in a young patient.
abstract: Purpose. Pathophysiology of macular hole (MH) is not yet well defined but the advances of spectral domain optical coherence tomography (SD-OCT) give us access to further detailed imaging. We report a case with macular inner segment ellipsoid (ISe) band loss and cone outer segment tips (COST) line changes seen in SD-OCT preceding MH appearance in a young patient. Methods. 21-year-old woman presented with a partial central scotoma, metamorphopsia, and a 20/25 vision in her right eye. Past medical history was positive for laser assisted in situ keratomileusis (LASIK) surgery 7 months ago with no complications. Macular SD-OCT showed ISe band loss and COST line elevation. She was followed a month later with visual acuity deteriorating to 20/200 and a full thickness MH. Results. The patient underwent a pars plana vitrectomy with internal limiting membrane peeling. Her visual acuity 2 months later was 20/20. Conclusion. SD-OCT can identify preliminary changes, yet to be described, preceding MH formation. Our patient demonstrated ISe band loss and COST abnormalities on SD-OCT a month prior to MH development. SD-OCT should be considered in young patients with subtle visual symptoms and mild changes in visual acuity that are not readily explained by ophthalmological exam.
authors.affiliation: Department of Ophthalmology, University of Colorado School of Medicine, Denver Health Medical Center, Denver, CO 80204, USA.
authors.forename: Mariana
authors.identifier: 0000-0002-3145-0720
authors.initials: M
authors.lastname: Harasawa
authors.affiliation: Rocky Mountains Lions Eye Institute, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Hugo
authors.identifier: 0000-0003-0063-9552
authors.initials: H
authors.lastname: Quiroz-Mercado
authors.affiliation: Department of Ophthalmology, University of Colorado School of Medicine, Denver Health Medical Center, Denver, CO 80204, USA.
authors.forename: Guillermo
authors.identifier: 0000-0003-2526-6342
authors.initials: G
authors.lastname: Salcedo-Villanueva
authors.affiliation: Association to Prevent Blindness in Mexico (APEC), Hospital Dr. Luis Sanchez Bulnes, 04030 Coyoacan, DF, Mexico.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Garcia-Aguirre
authors.affiliation: Department of Ophthalmology, University of Colorado School of Medicine, Denver Health Medical Center, Denver, CO 80204, USA.
authors.forename: Shulamit
authors.initials: S
authors.lastname: Schwartz