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idiopathic MH needing pars plan vitrectomy Knowing the integrity and changes in the
(PPV) and membrane peeling were included cone mosaic in macular hole helps to better
in the study. They were checked through understand the mechanism of closure and
extensive imaging (SD-OCT, IOL Master, Optos, identify imaging biomarkers that may be
and AO testing) before surgery and again at associated with better functional outcomes.
three months after surgery. Detailed studies could lead to improved surgical
techniques.
The results with eight patients (eight eyes)
with idiopathic MH, showed the cone density One of the limitations of the technology
before surgery was 11,793.92mm3 and at three is that its use can be time-intensive for
months after the surgery it was 12,181.6mm3. clinicians, according to Rajeev H Muni MD,
Also, pre-operative spacing was 24.2% and post- the senior author on the study and a
operatively it was 23.1%. Pre-operative regularity vitreoretinal surgeon at St. Michael’s Hospital,
was 85.8% and post-operative regularity was and vice-chairman of Clinical Research,
85.1%. Five patients had MH Stage 2, three Department of Ophthalmology and Vision
patients had Stage 3, and one patient had Sciences, University of Toronto.
Stage 4. All had successful closure of the MH.
It is easy to use but some training is required
To sum up, there was no statistical to efficiently obtain images. According to
difference in cone density, regularity or Muni, if the patient moves or does not fixate
dispersion when comparing pre- and post- on the target, it can be difficult to acquire
operatively. While the sample size was small, images. As a result, in some cases the process
they are looking at future research that will is time consuming. He adds that depending
involve a bigger sample. on the objective, performing imaging in many
quadrants and several eccentricities will take
The significance of the study is that it looked more time.
at the effect on cone mosaic following MH
surgery as it is known that that there is a shift AO retinal camera has a lot of potential in
of the retina after surgical repair of the macular research, as novel imaging biomarkers are
hole, and this is the first describing the change discovered that are associated with functional
in cone mosaic from baseline. So far, however, outcomes in various diseases. It has been used
there have been very few studies that describe for conditions other than MH, with several
the cone mosaic after surgical repair of MHs. applications in both medical and surgical retina.
66 | THE INDIAN OPTICIAN | SEPT-OCT 2022 TECH UPDATE
