Intraretinal Hyperreflective Foci as an OCT Feature Associated With Retinal Remodeling After Macular Hole Closure.
- 1Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy.
- 2IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Abstract
Purpose
To investigate intraretinal hyperreflective foci (HF) within the foveola in the healing process following surgical closure of full-thickness macular holes (FTMHs), using lamellar macular holes (LMHs) and vitreomacular traction (VMT) as comparisons.Methods
Analysis of spectral-domain optical coherence tomography (OCT) scans from 48 FTMH eyes undergoing surgery was conducted, with 14 LMH and 10 VMT eyes serving as controls. HF were defined as dot-like intraretinal lesions with reflectivity similar to the retinal nerve fiber layer and without back-shadowing, showing a vertical distribution pattern within the foveola. Baseline OCT parameters, including minimal linear diameter, basal diameter, hole height, and macular hole index (MHI), defined as the ratio between hole height and basal diameter, were assessed. HF patterns were evaluated in relation to external limiting membrane (ELM) restoration and ellipsoid zone (EZ) integrity after surgery.Results
Among the 48 FTMH eyes, 43 achieved successful closure (89.6%). HF were identified in all 43 eyes achieving anatomical closure at the first postoperative assessment, compared with 50% in LMH and 50% in VMT controls (P < 0.001). HF preceded complete ELM restoration in nine of 43 eyes (20.9%), whereas in the remaining cases both events were detected simultaneously at the same postoperative visit. At final follow-up, HF persisted in 86.0% of eyes and were associated with baseline larger base diameter (P = 0.044) and baseline lower macular hole index (MHI; P = 0.007). Complete EZ integrity was achieved in 65.1% of eyes and was significantly associated with HF resolution (P = 0.047) and better final visual acuity (P = 0.038).Conclusions
HF displaying a vertical pattern within the foveola may represent an early structural OCT feature associated with retinal remodeling after macular hole surgery. Further studies are needed to determine their biological significance and potential role as an imaging marker of macular hole healing.
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BibTeX
@article{valsecchi2026intraretinal,
title = {{Intraretinal Hyperreflective Foci as an OCT Feature Associated With Retinal Remodeling After Macular Hole Closure.}},
author = {Nicola Valsecchi and Giuseppe Gregorio Fusca and Luigi Apa and Francesca Del Monte and Claudio Scardovelli Fava and Alessandro Finzi and Antonio Moramarco and Maurizio Mete and Luigi Fontana},
journal = {Investigative ophthalmology \& visual science},
year = {2026},
month = oct,
doi = {10.1167/iovs.67.12.9},
url = {https://europepmc.org/article/MED/42831587},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intraretinal Hyperreflective Foci as an OCT Feature Associated With Retinal Remodeling After Macular Hole Closure.
AU - Nicola Valsecchi
AU - Giuseppe Gregorio Fusca
AU - Luigi Apa
AU - Francesca Del Monte
AU - Claudio Scardovelli Fava
AU - Alessandro Finzi
AU - Antonio Moramarco
AU - Maurizio Mete
AU - Luigi Fontana
PY - 2026
DA - 2026/10/01
JO - Investigative ophthalmology & visual science
DO - 10.1167/iovs.67.12.9
UR - https://europepmc.org/article/MED/42831587
AB - Purpose To investigate intraretinal hyperreflective foci (HF) within the foveola in the healing process following surgical closure of full-thickness macular holes (FTMHs), using lamellar macular holes (LMHs) and vitreomacular traction (VMT) as comparisons.Methods Analysis of spectral-domain optical coherence tomography (OCT) scans from 48 FTMH eyes undergoing surgery was conducted, with 14 LMH and 10 VMT eyes serving as controls. HF were defined as dot-like intraretinal lesions with reflectivity similar to the retinal nerve fiber layer and without back-shadowing, showing a vertical distribution pattern within the foveola. Baseline OCT parameters, including minimal linear diameter, basal diameter, hole height, and macular hole index (MHI), defined as the ratio between hole height and basal diameter, were assessed. HF patterns were evaluated in relation to external limiting membrane (ELM) restoration and ellipsoid zone (EZ) integrity after surgery.Results Among the 48 FTMH eyes, 43 achieved successful closure (89.6%). HF were identified in all 43 eyes achieving anatomical closure at the first postoperative assessment, compared with 50% in LMH and 50% in VMT controls (P < 0.001). HF preceded complete ELM restoration in nine of 43 eyes (20.9%), whereas in the remaining cases both events were detected simultaneously at the same postoperative visit. At final follow-up, HF persisted in 86.0% of eyes and were associated with baseline larger base diameter (P = 0.044) and baseline lower macular hole index (MHI; P = 0.007). Complete EZ integrity was achieved in 65.1% of eyes and was significantly associated with HF resolution (P = 0.047) and better final visual acuity (P = 0.038).Conclusions HF displaying a vertical pattern within the foveola may represent an early structural OCT feature associated with retinal remodeling after macular hole surgery. Further studies are needed to determine their biological significance and potential role as an imaging marker of macular hole healing.
SN - 0146-0404
SN - 1552-5783
ER -