Comparison of the Photoreceptor Mosaic Before and After Macular Hole Surgery With High-Resolution Adaptive Optics Imaging
Bibliographic record
Abstract
Purpose To assess the photoreceptor mosaic in patients with idiopathic full-thickness macular hole (MH) before and after pars plana vitrectomy (PPV) with adaptive optics enhanced retinal imaging (AO). Design Prospective case series. Methods Prospective cohort study of patients who presented at the Kensington Eye Institute, Toronto, Canada with a diagnosis of MH treated with PPV. Exclusion criteria: secondary MH, high myopia (axial length >26.5 mm), media opacity precluding optical coherence tomography or AO imaging, previous intraocular surgery except for cataract extraction. Imaging using an AO fundus camera (Imagine Eyes, RTX1) was performed preoperatively and 3 months following successful MH repair in both eyes. Cone density (CD), regularity, dispersion, and spacing were measured at 2° and/or 4° of eccentricity in 4 quadrants (superior, inferior, nasal, and temporal) with pre- and postoperative values compared. Results We included 18 eyes of 9 patients. At 2° there was significant reduction in CD and increase in spacing and dispersion and a nonsignificant change in regularity postoperatively. Comparison between preoperative and postoperative measurements at 2° mean (standard error) were: CD: 14,612 ± 3003 and 12,280 ± 4632 photoreceptors/mm 2 (95% CIs=–2413 to –702) P = .0004, regularity: 88% ± 7% and 84% ± 12% (95% CIs=–4.67 to 0.04) P = .054, dispersion: 19% ± 6% and 23% ± 10% (95% CIs=0.5-4.24) P = .013, spacing: 9 ± 1 microns and 10 ± 2 microns (95% CIs=0.40-1.27) P = .0002; at 4° was: CD: 13,377 ± 4339 and 12,770 ± 4391 photoreceptors/mm 2 (95% CIs=–1368 to 252) P = .176, regularity:87% ± 9% and 86% ± 12% (95% CIs=–4.65 to 0.08) P = .74, dispersion: 20% ± 8% and 20% ±9% (95% CIs=–2.11 to 1.5) P = .74, spacing:10 ± 2 microns and 10 ± 3 microns (95% CIs=–0.23 to 0.58) P = .39. Conclusions AO imaging allows quantitative assessment of the photoreceptor mosaic pre- and post-PPV in patients with MH. There was a significant change to the photoreceptor mosaic related to the MH at 2° pre- and postoperatively. AO imaging enables high-resolution investigation of the photoreceptor remodeling process following surgery, which may allow for a more thorough assessment of surgical outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".