Inner Segment Ellipsoid Band and Cone Outer Segment Tips Changes Preceding Macular Hole Development in a Young Patient. (4th December 2014)

• Record Type: Journal Article
• Authors: Harasawa, Mariana; Quiroz-Mercado, Hugo; Salcedo-Villanueva, Guillermo; Garcia-Aguirre, Gerardo; Schwartz, Shulamit
• Other Names: Arevalo J. Fernando Academic Editor.
• Is Part Of: Case reports in ophthalmological medicine. Volume 2014(2014)
• Publication Date: 2014-12-04
• Subjects: Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Ophthalmology; Eye Diseases; Eye -- Diseases; Ophthalmology; Electronic journals; Periodicals; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 617.7
• DOI: 10.1155/2014/132565
• Languages: English
• ISSNs: 2090-6722

Abstract

Abstract : Purpose . Pathophysiology of macular hole (MH) is not yet well defined but the advances of spectral domain optical coherence tomography (SD-OCT) give us access to further detailed imaging. We report a case with macular inner segment ellipsoid (ISe) band loss and cone outer segment tips (COST) line changes seen in SD-OCT preceding MH appearance in a young patient. Methods . 21-year-old woman presented with a partial central scotoma, metamorphopsia, and a 20/25 vision in her right eye. Past medical history was positive for laser assisted in situ keratomileusis (LASIK) surgery 7 months ago with no complications. Macular SD-OCT showed ISe band loss and COST line elevation. She was followed a month later with visual acuity deteriorating to 20/200 and a full thickness MH. Results . The patient underwent a pars plana vitrectomy with internal limiting membrane peeling. Her visual acuity 2 months later was 20/20. Conclusion . SD-OCT can identify preliminary changes, yet to be described, preceding MH formation. Our patient demonstrated ISe band loss and COST abnormalities on SD-OCT a month prior to MH development. SD-OCT should be considered in young patients with subtle visual symptoms and mild changes in visual acuity that are not readily explained by ophthalmological exam.