![]() Furthermore, depending on the objective, performing imaging in many quadrants and several eccentricities will take more time.” As a result, in some cases the image acquisition process is time-consuming. “However, if the patient moves or does not fixate on the target, it can be difficult to acquire images. ![]() “There is some training that is required before learning how to efficiently obtain images,” Muni explained. The senior author on the study, Dr Muni is a vitreoretinal surgeon at St Michael’s Hospital, Toronto and Kensington Eye Institute, and vice-chairman of clinical research in the Department of Ophthalmology and Vision Sciences at the University of Toronto, Canada. One of the limitations of the technology is that its use can be time-intensive for clinicians, explained Rajeev H. “Eventually this could lead to improved surgical techniques.” Limitations “It is important to know the integrity and changes in the cone mosaic in macular hole to better understand the mechanism of closure and identify imaging biomarkers that may be associated with better functional outcomes,” Dr Oquendo said. Moreover, she pointed out, this is the first study describing the change in cone mosaic from baseline. “However, there are very few studies that describe the cone mosaic after surgical repair of MHs.” “It is well reported that there is a shift of the retina after surgical repair of the macular hole,” she said. Oquendo explained that the significance of the study is that it looked at the effect on cone mosaic following MH surgery. “This initial study was a pilot project to assess the cone mosaic before and after surgery, and larger studies will be useful to assess AO imaging biomarkers with variations in surgical technique for macular hole closure.” “We would like to continue recruiting patients to enlarge the sample size and get more meaningful data,” she said. Moreover, Oquendo noted that the sample size in this study was small. “The sample size was relatively small, but the study demonstrated that AO (rtx1 retinal camera) may be a useful method of assessing integrity of the cone mosaic following macular hole repair.” “There was no statistical difference in cone density, regularity or dispersion when comparing pre- and postoperatively,” Oquendo explained. Five patients had stage 2 MHs, three had stage 3 and one had stage 4. Preoperative regularity was 85.8%, and postoperative regularity was 85.1%. In addition, average preoperative spacing was 24.2%, and postoperatively it was 23.1%. In terms of results with eight patients (eight eyes) with idiopathic MH, cone density before surgery was 11,793.92 mm3,and at 3 months postoperatively it was 12,181.6 mm3. Patients underwent extensive imaging before surgery and at 3 months postoperatively, according to Oquendo. The study included individuals presenting to the Kensington Vision and Research Centre in Toronto with idiopathic MH needing pars plana vitrectomy and membrane peeling. This could possibly result in a reduction of cone density temporally.”ĭiscussing MH and photoreceptor changes using high-resolution imaging with adaptive optics, Oquendo described the results of a small study that used an AO retinal camera (rtx1, Imagine Eyes) and spectral-domain optical coherence tomography (SD-OCT) to evaluate the photoreceptors in patients with various morphologies of MH and the changes following surgical closure. “This is because it is likely that the temporal retina stretches to close the macula hole. “We hypothesized that cone density will change following macular hole closure,” said Oquendo, a vitreoretinal clinical research fellow at St Michael’s Hospital Toronto and the Department of Ophthalmology and Vision Sciences at the University of Toronto in Canada. Oquendo, MD, at the 2022 Canadian Ophthalmological Society Annual Meeting and Exhibition held in Halifax, Nova Scotia, Canada. An adaptive optics (AO) retinal camera has been used to measure photoreceptors preoperatively and following macular hole (MH) surgery to accurately assess any changes in cone density, according to research presented by Paola L.
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