Macular hole formation, progression, and surgical repair: case series of serial optical coherence tomography and time lapse morphing video study

<p>Abstract</p> <p>Background</p> <p>To use a new medium to dynamically visualize serial optical coherence tomography (OCT) scans in order to illustrate and elucidate the pathogenesis of idiopathic macular hole formation, progression, and surgical closure.</p> <p>Case Presentations</p> <p>Two patients at the onset of symptoms with early stage macular holes and one patient following repair were followed with serial OCTs. Images centered at the fovea and at the same orientation were digitally exported and morphed into an Audiovisual Interleaving (avi) movie format. Morphing videos from serial OCTs allowed the OCTs to be viewed dynamically. The videos supported anterior-posterior vitreofoveal traction as the initial event in macular hole formation. Progression of the macular hole occurred with increased cystic thickening of the fovea without evidence of further vitreofoveal traction. During cyst formation, the macular hole enlarged as the edges of the hole became elevated from the retinal pigment epithelium (RPE) with an increase in subretinal fluid. Surgical repair of a macular hole revealed initial closure of the macular hole with subsequent reabsorption of the sub-retinal fluid and restoration of the foveal contour.</p> <p>Conclusions</p> <p>Morphing videos from serial OCTs are a useful tool and helped illustrate and support anterior-posterior vitreofoveal traction with subsequent retinal hydration as the pathogenesis of idiopathic macular holes.</p

Comparison of optical coherence tomography models OCT1 and Stratus OCT for macular retinal thickness measurement

Aims: To compare the values measured for retinal macular thickness with the first and last generations of the optical coherence tomograph (OCT1 and Stratus OCT, Zeiss, Humphrey Division). Methods: This was a cohort study. 59 eyes were examined: 17 had a normal macula and 42 had a diabetic macular oedema. In each eye, mean retinal thickness (RT) was measured automatically in the nine macular Early Treatment Diabetic Retinopathy Study areas and at the foveal centre, using OCT1 and Stratus OCT. The paired mean RT values for each area and the type and proportion of artefacts were compared. Results: Of the 590 automatic measurements, 505 had no artefact, either with OCT1 or Stratus OCT. The mean difference between the OCT1 and Stratus OCT measurements was 25 (SD 26.2) μm (p<0.0001). With Stratus OCT, RT values were significantly higher, by 8.1% (7.8%), than with OCT1. Artefacts were only observed in cases of diabetic macular oedema and were significantly more frequent with OCT1 than Stratus OCT (10.5% versus 4.4, p<0.0001). Conclusion: The macular retinal thickness values measured with Stratus OCT were significantly higher than those measured with OCT1. Stratus OCT has the advantage of producing fewer artefacts than OCT1 in pathological cases