Multimodal Imaging Analysis of Supra-retinal Pigment Epithelium Granular Deposits in Treatment-Naive Full-Thickness Macular Holes

IF 5.7 Q1 OPHTHALMOLOGY Ophthalmology. Retina Pub Date : 2025-08-01 Epub Date: 2025-02-24 DOI:10.1016/j.oret.2025.02.016
Daniela Bacherini MD, PhD , Stefano Mercuri MD , Andrea Govetto MD, PhD , Laura Di Leo MD , Tomaso Caporossi MD , Francesco Faraldi MD , Stanislao Rizzo MD , Gianni Virgili MD , Fabrizio Giansanti MD, PhD
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Abstract

Purpose

To describe the morphology and provide anatomical correlations of supra-retinal pigment epithelium (RPE) granular deposits in full-thickness macular holes (FTMHs).

Design

Retrospective, observational, single-center study.

Participants

Patients with idiopathic FTMH presenting to the University of Florence Eye clinic.

Methods

Thirty-six eyes of 34 patients with a diagnosis of treatment-naive FTMH, scheduled for surgery, underwent multimodal imaging including spectral-domain OCT (SD-OCT), en-face OCT, and adaptive optics ophthalmoscopy (AOO). Different methodologies were evaluated to determine the location and topographical correspondence of granulations. The total volume of supra-RPE granular deposits was correlated to the macular hole (MH) characteristics and SD-OCT markers of photoreceptor damage with Spearman correlation coefficient (CC).

Main Outcome Measures

Morphological correlations in FTMHs using SD-OCT and AOO.

Results

Using AOO, supra-RPE granular deposits appeared as hyper-reflective structures, mostly found within the minimum linear diameter (MLD) (104 of 139 deposits, 74%). Different imaging techniques were equally effective in the topographical identification of supra-RPE granular deposits (P > 0.30). The total volume of supra-RPE granular deposits significantly increased with stages B and C of FTMH, inversely correlated to the corrected ellipsoid zone (EZ) reflectivity (CC = −0.62) and positively correlated to the length of the EZ defect (CC = +0.41) and MH diameter at the base (CC = +0.35) and MLD (CC = +0.42) (all P < 0.05).

Conclusions

Supra-RPE granular deposits can be identified accurately using AOO and en-face OCT. Characteristics using AOO and anatomical correlations at SD-OCT indicate supra-RPE granular deposits as signs of photoreceptor degeneration.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.
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治疗初期全层黄斑孔视网膜上色素上皮颗粒沉积的多模态成像分析。
目的:描述全层黄斑孔(FTMHs)视网膜上色素上皮(RPE)颗粒沉积的形态学和解剖学相关性。设计:回顾性、观察性、单中心研究参与者:到佛罗伦萨大学眼科诊所就诊的特发性FTMH患者方法:34例诊断为治疗初期FTMH的患者36只眼,计划手术,接受多模态成像,包括光谱域光学相干断层扫描(SD-OCT)、正面OCT和自适应光学眼底镜检查(AOO)。评估了不同的方法来确定颗粒的位置和地形对应性。超rpe颗粒沉积物的总体积与MH特征和光感受器损伤的SD-OCT标志物具有Spearman相关系数(CC)。结果:利用AOO法,超rpe颗粒状沉积物呈现超反射结构,主要分布在最小线径(MLD)范围内(104/139,74%)。不同的成像技术在超rpe颗粒矿床的地形识别中同样有效(p>0.30)。超rpe颗粒沉积物的总体积随着FTMH的B、C阶段显著增加,与校正椭球区(EZ)反射率(CC=-0.62)呈负相关,与EZ缺陷长度(CC=+0.41)、底部MH直径(CC=+0.35)、MLD (CC=+0.42)呈正相关(均p < 0.05)。超rpe颗粒沉积可以通过AOO和正面oct准确识别。在SD-OCT上,AOO和解剖相关性表明超rpe颗粒沉积是光感受器变性的标志。
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来源期刊
Ophthalmology. Retina
Ophthalmology. Retina Medicine-Ophthalmology
CiteScore
7.80
自引率
6.70%
发文量
274
审稿时长
33 days
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