Assessing Photoreceptor Structure in Macular Hole using Split-detector Adaptive Optics Scanning Light Ophthalmoscopy European Ophthalmic Review European Ophthalmic Review, 2015;9(1):59–63 DOI: 10.17925/EOR.2015.09.01.59
Date
09/01/2015Abstract
Macular hole (MH) and vitreomacular traction (VMT) can involve disruption at the level of the photoreceptor interdigitation zone (IZ) and ellipsoid zone (EZ) with optical coherence tomography (OCT). Confocal adaptive optics scanning light ophthalmoscopy (AOSLO) has been used to examine the photoreceptor mosaic following surgical intervention in patients with MH and VMT, showing large ‘dark areas’ devoid of normal waveguiding cones. Using split-detector AOSLO, which allows visualisation of cone photoreceptor inner segments, we examined the macular cone structure in these disruptions. Methods: Seven eyes from six subjects with MH or VMT were imaged with spectral domain OCT (SD-OCT), confocal AOSLO and non-confocal split-detection AOSLO following pars plana vitrectomy (PPV) for MH or intravitreal injection with ocriplasmin for VMT. Results: Split-detector AOSLO imagery revealed remnant inner segment structure within dark areas observed with confocal AOSLO. In addition, split-detector images demonstrated that not all hyperreflective dots in confocal AOSLO images were derived from cones. Conclusion: Split-detector AOSLO provides additional information for these retinal conditions, and is likely to become an invaluable tool for assessing residual cone structure in conditions where disrupted cone structure interferes with the ability to visualise cells with confocal AOSLO.
Author List
Edward L Randerson, Drew Davis, Brian Higgins, Judy E Kim, Dennis P Han, Thomas B Connor, William J Wirostko, Joseph CarrollAuthor
William Wirostko MD Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinView Online
