Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging

Unnikrishnan Nair,1,2 Jay U Sheth,1,2 Asmita Indurkar,1 Manoj Soman1,2 1Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India; 2Department of Research, Chaithanya Innovation in Technology and Eyecare (Research), Trivandrum, Kerala, IndiaCorrespondence: Jay...

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Autores principales: Nair U, Sheth JU, Indurkar A, Soman M
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:5687ea49c7844280a7ecb18561abae8e2021-12-02T18:31:00ZIntraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging1177-5483https://doaj.org/article/5687ea49c7844280a7ecb18561abae8e2021-07-01T00:00:00Zhttps://www.dovepress.com/intraretinal-cysts-in-macular-hole-a-structure-function-correlation-ba-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Unnikrishnan Nair,1,2 Jay U Sheth,1,2 Asmita Indurkar,1 Manoj Soman1,2 1Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India; 2Department of Research, Chaithanya Innovation in Technology and Eyecare (Research), Trivandrum, Kerala, IndiaCorrespondence: Jay U Sheth 32, Shiv-Mahal, Mathuradas Road, Kandivali (West), Mumbai, 400067, Maharashtra, IndiaTel +91 9961167200Email drjay009@gmail.comPurpose: To characterize retinal micromorphic changes on en face optical coherence tomography (OCT) and to determine their role in pathogenesis and visual outcomes in macular hole (MH) surgery.Patients and Methods: This is a retrospective, interventional, consecutive case series of 28 eyes undergoing successful MH surgery. Pre- and post-operative en face OCT were manually segmented, and the correlation between parameters such as MH basal diameter and minimal inlet area, area of cyst in inner plexiform layer (IPL) and outer plexiform layer (OPL), percentage of cyst in IPL and OPL, and amount of ellipsoid zone (EZ) defect and external limiting membrane (ELM) defect was performed. Their relationship with visual acuity (VA) outcomes (Group 1: ≥ 20/60; 14 eyes; Group 2: < 20/60; 14 eyes) was also evaluated.Results: A significant positive correlation was noted between the cyst area in OPL and IPL (r=0.768; p< 0.001), which in turn were positively correlated with the basal diameter of the MH in all eyes. The cyst area was significantly more in IPL as compared to OPL in all eyes (p=0.049) and in group 2 (p=0.03) but not in group 1 (p=0.62). As compared to group 2, eyes in group 1 had significantly better pre- and post-operative VA, and significantly smaller basal diameter, minimal inlet area, area of cyst in IPL and OPL, and amount of defect in the ELM (postoperative) and EZ (pre- and post-operative), respectively.Conclusion: An increase in the basal diameter of the MH is associated with a simultaneous congruous enlargement of the area of cyst in IPL and OPL. Based on these imaging findings, we propose that the possible rationale for the origin of these intraretinal cysts could be a breakdown in the physiological retinal pigment epithelium (RPE) pump due to the anatomical separation of the neurosensory retina from the underlying RPE, ie, “RPE contact loss” theory.Keywords: macular hole, spectral-domain optical coherence tomography, en face imaging, intraretinal cystsNair USheth JUIndurkar ASoman MDove Medical Pressarticlemacular holespectral-domain optical coherence tomographyen face imagingintraretinal cystsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2953-2962 (2021)
institution DOAJ
collection DOAJ
language EN
topic macular hole
spectral-domain optical coherence tomography
en face imaging
intraretinal cysts
Ophthalmology
RE1-994
spellingShingle macular hole
spectral-domain optical coherence tomography
en face imaging
intraretinal cysts
Ophthalmology
RE1-994
Nair U
Sheth JU
Indurkar A
Soman M
Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
description Unnikrishnan Nair,1,2 Jay U Sheth,1,2 Asmita Indurkar,1 Manoj Soman1,2 1Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India; 2Department of Research, Chaithanya Innovation in Technology and Eyecare (Research), Trivandrum, Kerala, IndiaCorrespondence: Jay U Sheth 32, Shiv-Mahal, Mathuradas Road, Kandivali (West), Mumbai, 400067, Maharashtra, IndiaTel +91 9961167200Email drjay009@gmail.comPurpose: To characterize retinal micromorphic changes on en face optical coherence tomography (OCT) and to determine their role in pathogenesis and visual outcomes in macular hole (MH) surgery.Patients and Methods: This is a retrospective, interventional, consecutive case series of 28 eyes undergoing successful MH surgery. Pre- and post-operative en face OCT were manually segmented, and the correlation between parameters such as MH basal diameter and minimal inlet area, area of cyst in inner plexiform layer (IPL) and outer plexiform layer (OPL), percentage of cyst in IPL and OPL, and amount of ellipsoid zone (EZ) defect and external limiting membrane (ELM) defect was performed. Their relationship with visual acuity (VA) outcomes (Group 1: ≥ 20/60; 14 eyes; Group 2: < 20/60; 14 eyes) was also evaluated.Results: A significant positive correlation was noted between the cyst area in OPL and IPL (r=0.768; p< 0.001), which in turn were positively correlated with the basal diameter of the MH in all eyes. The cyst area was significantly more in IPL as compared to OPL in all eyes (p=0.049) and in group 2 (p=0.03) but not in group 1 (p=0.62). As compared to group 2, eyes in group 1 had significantly better pre- and post-operative VA, and significantly smaller basal diameter, minimal inlet area, area of cyst in IPL and OPL, and amount of defect in the ELM (postoperative) and EZ (pre- and post-operative), respectively.Conclusion: An increase in the basal diameter of the MH is associated with a simultaneous congruous enlargement of the area of cyst in IPL and OPL. Based on these imaging findings, we propose that the possible rationale for the origin of these intraretinal cysts could be a breakdown in the physiological retinal pigment epithelium (RPE) pump due to the anatomical separation of the neurosensory retina from the underlying RPE, ie, “RPE contact loss” theory.Keywords: macular hole, spectral-domain optical coherence tomography, en face imaging, intraretinal cysts
format article
author Nair U
Sheth JU
Indurkar A
Soman M
author_facet Nair U
Sheth JU
Indurkar A
Soman M
author_sort Nair U
title Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
title_short Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
title_full Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
title_fullStr Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
title_full_unstemmed Intraretinal Cysts in Macular Hole: A Structure-Function Correlation Based on En Face Imaging
title_sort intraretinal cysts in macular hole: a structure-function correlation based on en face imaging
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/5687ea49c7844280a7ecb18561abae8e
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AT indurkara intraretinalcystsinmacularholeastructurefunctioncorrelationbasedonenfaceimaging
AT somanm intraretinalcystsinmacularholeastructurefunctioncorrelationbasedonenfaceimaging
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