Preliminary implementation of a novel high magnification mod
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Since a novel high magnification module (HMM) combined with OCT (OCT-HMM) can detect the microstructure of the retina, researchers are using it to investigate the ultrastructure of the macula after surgery to close an idiopathic macular hole (IMH).

This is an observational case series study in which patients with full-thickness IMHs who had undergone successful macular closure by vitrectomy and internal limiting membrane peeling and healthy subjects were recruited. After comprehensive ophthalmic examinations, the images of macular area were obtained and collected by professional operators using OCT-HMM. Then images were independently analyzed by 4 masked vitreoretinal specialists.

A total of 24 IMH eyes and 42 healthy eyes were examined. HMM images were obtained in 10 IMH eyes.

--Among them, 4 eyes whose macula closed completely with recovery of photoreceptor layer presented a dark arc nasal to the fovea, oriented to the optic, and the notch of arc faced temporally.

--6 eyes in which the macula closed incompletely with photoreceptor cells loss revealed a dark ring with uneven bright spots inside. The other 14 eyes failed to obtain clear images by OCT-HMM.

--The contra lateral eyes of the patients and the healthy subjects eyes succeeded to obtain the HMM images which displayed evenly grey background thickly covered with tiny bright dots that was in similar size and evenly and widely distributed and there no dark arc or ring.

--OCT B-scan and IR images could be acquired in all of the IMH and healthy eyes.

Finally, the preliminary implementation of HMM has provided with a completely new understanding of the microstructure of closed IMH. With OCT-HMM, a dark arc sign in the macula that was functionally closed after surgery was found, which was most likely the healing mark on a microstructure photoreceptor stage. Its presence and shape suggested that the functional closure was accompanied by a retinal displacement, mostly horizontally from the temporal to the nasal sides, but not symmetrically.