Inner Segment Ellipsoid Band and Cone Outer Segment Tips Changes Preceding Macular Hole Development in a Young Patient

Abstract EN

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.