Photoreceptor layer assessed in tissue layer image using spectral-domain optical coherence tomography after surgical closure of macular hole.

Purpose: To investigate changes in the photoreceptor layer in tissue layer images using spectral-domain optical coherence tomography after macular hole surgery.

Methods: Visual acuity and spectral-domain optical coherence tomography scans were obtained in 24 eyes with surgically closed macular holes prospectively at 1, 2, 4, and 6 months after surgery. The scanned data were processed to generate tissue layer images of the photoreceptor layer, namely, photoreceptor layer map. Hyporeflective area and reflectivity at the fovea were analyzed to find a correlation with visual acuity.

Results: Mean visual acuity improved from 48.1 letters preoperatively to 62.5 letters at 1 month and to 73.8 letters at 6 months. Hyporeflective area in the photoreceptor layer map corresponded to attenuated signals from the junction of the inner and outer segments of the photoreceptors. Hyporeflective area decreased from 1.54 mm at 1 month to 0.60 mm at 6 months. Foveal reflectivity increased from 0.77 to 0.85. Visual acuity correlated with the hyporeflective area (r = 0.43-0.63) and foveal reflectivity (r = 0.35-0.61).

Conclusion: After macular hole closure, attenuated signal from the junction of the inner and outer segments of the photoreceptors representing disorganization of the photoreceptor layer was shown in the photoreceptor layer map as a hyporeflective area, which correlated with the postoperative visual acuity. Hyporeflectivity decreased gradually with concurrent improvement in visual acuity.