Ultrastructural study of closed macular hole- preliminary application of a novel high magnification module combining with OCT

Chang-Yu Qiu,Qian-Qian Xu,Hong-Wei Zhao,Ling Luo,Yuan-Yuan Shi,Xiao-Hua Guo,Chuang Nie,Fei-Long Song,Jun Zhao,Chang-Ying Liu,Ming-Xia Dong,Huai-Qiang Zhang,Lin Shi,Yu-Bo Gong

doi:10.1186/s12886-021-01801-0

Abstract

BackgroundAs a novel high magnification module (HMM) combining with OCT (OCT-HMM) is able to detect the microstructure of retina, we apply it to explore the ultrastructure of the macula after closure of the idiopathic macular hole (IMH) by surgery.MethodsThis is an observational case series study in which patients with full-thickness IMHs who had undergone successful macular closure by vitrectomy and internal limiting membrane peeling and healthy subjects were recruited. After comprehensive ophthalmic examinations, the images of macular area were obtained and collected by professional operators using OCT-HMM. Then images were independently analyzed by 4 masked vitreoretinal specialists.ResultsA total of 24 IMH eyes and 42 healthy eyes were examined. HMM images were obtained in 10 IMH eyes. Among them, 4 eyes whose macula closed completely with recovery of photoreceptor layer presented a dark arc nasal to the fovea, oriented to the optic, and the notch of arc faced temporally. Six eyes in which the macula closed incompletely with photoreceptor cells loss revealed a dark ring with uneven bright spots inside. The other 14 eyes failed to obtain clear images by OCT-HMM. The contra lateral eyes of the patients and the healthy subjects’ eyes succeeded to obtain the HMM images which displayed evenly grey background thickly covered with tiny bright dots that was in similar size and evenly and widely distributed and there no dark arc or ring. OCT B-scan and IR images could be acquired in all of the IMH and healthy eyes.ConclusionThe preliminary application of HMM has supplied us a brand-new insight into the microstructure of closed IMH. A dark arc sign could be detected with OCT-HMM in the macula which was functionally closed after surgery that was probably the healing mark on a microstructure photoreceptors level. Its existence and shape indicated that the functional closure followed by a retinal displacement mainly horizontally from temporal side to nasal side but not symmetric centripetally.

Highlights

As a novel high magnification module (HMM) combining with optical coherence tomography (OCT) (OCT-High Magnification Module (HMM)) is able to detect the microstructure of retina, we apply it to explore the ultrastructure of the macula after closure of the idiopathic macular hole (IMH) by surgery
A dark arc sign could be detected with High magnification module combining with OCT (OCT-HMM) in the macula which was functionally closed after surgery that was probably the healing mark on a microstructure photoreceptors level
All of IMHs have closed as shown in OCT B-scan

Summary

Introduction

As a novel high magnification module (HMM) combining with OCT (OCT-HMM) is able to detect the microstructure of retina, we apply it to explore the ultrastructure of the macula after closure of the idiopathic macular hole (IMH) by surgery. At present, benefiting from its high resolution and powerful data processing capacity, OCT cannot only clearly display the subtle structure of different layers of retina, and noninvasive dynamic observation and measurement of retinal vessels. It can distinguish the tissues during the operation in real time [8]. (Investigate the retina at the microstructural level) It is called High Magnification Module (HMM). Here’s a preliminary application of HMM in healthy subjects and post-operation MH patients

Methods

Results

Discussion

Conclusion