Internal retinal layer thickness and macular migration after internal limiting membrane peeling in macular hole surgery

2017 ◽  
Vol 28 (3) ◽  
pp. 311-316 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Sofia Mano ◽  
Diana M. Cristóvao ◽  
David C. Sousa ◽  
...  
Keyword(s):  
Macular Hole ◽  
Layer Thickness ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Retinal Layer ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Internal Limiting Membrane Peeling ◽  
Retinal Layers ◽  
Sd Oct

Purpose: To provide a spectral-domain optical coherence tomography (SD-OCT)-based analysis of retinal layers thickness and nasal displacement of closed macular hole after internal limiting membrane peeling in macular hole surgery. Methods: In this nonrandomized prospective interventional study, 36 eyes of 32 patients were subjected to pars plana vitrectomy and 3.5 mm diameter internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH). Nasal and temporal internal retinal layer thickness were assessed with SD-OCT. Each scan included optic disc border so that distance between optic disc border and fovea were measured. Results: Thirty-six eyes had a successful surgery with macular hole closure. Total nasal retinal thickening (p<0.001) and total temporal retinal thinning (p<0.0001) were observed. Outer retinal layers increased thickness after surgery (nasal p<0.05 and temporal p<0.01). Middle part of inner retinal layers (mIRL) had nasal thickening (p<0.001) and temporal thinning (p<0.05). The mIRL was obtained by deducting ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness from overall thickness of the inner retinal layer. Papillofoveal distance was shorter after ILM peeling in macular hole surgery (3,651 ± 323 μm preoperatively and 3,361 ± 279 μm at 6 months; p<0.0001). Conclusions: Internal limiting membrane peel is associated with important alteration in inner retinal layer architecture, with thickening of mIRL and shortening of papillofoveal distance. These factors may contribute to recovery of disrupted foveal photoreceptor and vision improvement after IMH closure.

Tomographic Structural Changes of Retinal Layers after Internal Limiting Membrane Peeling for Macular Hole Surgery

2017 ◽  
Vol 59 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Mun Yueh Faria ◽  
Nuno P. Ferreira ◽  
Diana M. Cristóvao ◽  
Sofia Mano ◽  
David Cordeiro Sousa ◽  
...  
Keyword(s):  
Macular Hole ◽  
Structural Changes ◽  
Internal Limiting Membrane ◽  
Macular Hole Surgery ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Retinal Layers

scholarly journals Long-Term Observations of Thickness Changes of Each Retinal Layer following Macular Hole Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Atsushi Tada ◽  
Shigeki Machida ◽  
Yuji Hara ◽  
Satoshi Ebihara ◽  
Masahiko Ishizuka ◽  
...  
Keyword(s):  
Macular Hole ◽  
Medical Records ◽  
Retinal Thickness ◽  
Internal Limiting Membrane ◽  
Embedded Software ◽  
Retinal Layer ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Baseline Values

Purpose. To determine the long-term changes of the thickness of each retinal layer following macular hole (MH) surgery combined with internal limiting membrane (ILM) peeling. Method. The medical records of 42 eyes of 42 patients (41 to 86 years of age) who underwent MH surgery with ILM peeling between February 2016 and October 2018 were reviewed. A single surgeon operated on all patients, and all were followed for at least 24 months postoperatively. Spectral-domain optical coherence tomography (OCT) was performed to obtain retinal thickness maps of the parafoveal region corresponding approximately to the ILM peeled area. Each retinal layer was automatically segmented by the embedded software, and thickness maps were constructed for the total retinal layer (TRL), inner RL (IRL), middle RL (MRL), and outer RL (ORL). The averaged value of each retinal layer thickness was analyzed in the temporal/upper, temporal/lower, nasal/upper, and nasal lower quadrants. Results. The TRL thickness was significantly decreased in the temporal areas postoperatively. The IRL thickness thinned progressively and significantly until 6 months without further thinning in the temporal quadrants. The MRL thickness of all areas was significantly thicker than the baseline values at 0.5 months and then gradually decreased in the temporal regions. However, the thickening in the nasal regions returned to the baseline values after 1.5 months. The ORL decreased transiently relative to the baseline values at 0.5 months in all areas. Conclusions. The ILM peeling does not affect only the thickness of the inner retina but also the middle and outer retinae in the parafoveal region. The chronological changes of the thickness after surgeries varied among the retinal layers and macular regions.

scholarly journals Multifocal Electroretinography in Assessment of Macular Function after Internal Limiting Membrane Peeling in Macular Hole Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
M. Y. Faria ◽  
D. C. Sousa ◽  
S. Mano ◽  
R. Marques ◽  
N. P. Ferreira ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Multifocal Electroretinography ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Macular Function ◽  
Retinal Layers ◽  
Snellen Visual Acuity

Purpose. Internal limiting membrane (ILM) peeling is important for macular hole (MH) surgery but may have secondary effects visible on spectral domain optical coherence tomography (OCT) and multifocal electroretinography (mfERG). We relate integrity of inner and outer macular layers with functional results with mfERG. Methods. Nonrandomized prospective study of 33 consecutive eyes of 33 patients with macular hole who underwent vitrectomy with ILM peeling. Best-corrected visual acuity was assessed, and integrity of external layers was measured using OCT. Each component of mfERG, N1 and P1 amplitude and latency, was also measured. Results. All eyes showed macular hole closure. Visual acuity improved from 20/400 to 20/40 in the Snellen visual acuity chart (P<0.001), and OCT external lines were intact in 19 eyes and disrupted in 14 eyes. Postoperatively, N1 and P1 amplitudes in ring 1 increased compared to preoperative values (P<0.001 for both). Latency remained delayed for both N1 and P1 wave. In the group of 19 eyes with integrity of outer retinal layers, N1 amplitude in ring 1 was superior to the group of 14 patients with disrupted outer retinal layers (P=0.042). Conclusions. In macular hole surgery, structure analysis in OCT is one of the important outcomes for the retinal surgeon. Functional results are parallel with anatomic results, but visual gain is limited. The limited recovery in mfERG suggests an alteration of retinal physiology that could explain limited vision recover.

scholarly journals Choroidal and retinal displacements after vitrectomy with internal limiting membrane peeling in eyes with idiopathic macular hole

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kensuke Goto ◽  
Takeshi Iwase ◽  
Tomohiko Akahori ◽  
Kentaro Yamamoto ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Oct Angiography ◽  
Optical Coherence ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
En Face

AbstractIt has been reported that the macular region of the retina is displaced after vitrectomy with internal limiting membrane (ILM) peeling in eyes with macular hole (MH), but the displacements of the deeper layers of the eye, e.g. RPE and choroid are unclear following the surgery. We used optical coherence tomography (OCT) and OCT angiography (OCTA) to obtain 3 mm × 3 mm en face images before, and 2, 4, and 8 weeks following the vitrectomy with internal limiting membrane (ILM) peeling from 22 eyes of 22 patients with a MH. The OCT and OCTA images showed displacements of the fovea and choroidal intermediate vessels postoperatively. The degree of displacement of the choroid was significantly less than that of the retina (P < 0.001). The displacements of the choroidal bifurcations were significantly correlated to their preoperative distance from the optic disc (r = −0.467, P < 0.001) and they were significantly correlated with the retinal displacements (r = 0.535, P < 0.001). The retina was displaced inferiorly and centripetally, but these localized displacements were not observed in the choroid. In conclusion, clinicians need to be aware of these displacements when evaluating the subfoveal choroid following the surgery because the displacement is different between the retina and the choroid.

scholarly journals Displacement of the retina after idiopathic macular hole surgery with different internal limiting membrane peeling patterns

2021 ◽  
Vol 14 (9) ◽  
pp. 1408-1412
Author(s):  
Jin Liu ◽  
◽  
Xin-Hua Zheng ◽  
Yuan-Long Li ◽  
Jun-Long Huang ◽  
...  
Keyword(s):  
Macular Hole ◽  
Influencing Factor ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Significant Difference

AIM: To explore retinal displacement after surgical treatment for idiopathic macular hole (IMH) with different internal limiting membrane (ILM) peeling patterns. METHODS: Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups, N-T group (11 eyes) and T-N group (11 eyes). For patients in N-T group, ILM was peeled off from nasal to temporal retina. For patients in T-N group, ILM was peeled off from temporal to nasal retina. Preoperative, postoperative 1, 3, and 6mo, autofluorescence fundus images were collected for manual measurement of distances of fixed nasal (N), temporal (T), superior (S), and inferior (I) retinal points (bifurcation or crossing of retinal vessels) around the macula to the optic disc (OD). These were respectively defined as N-OD, T-OD, S-OD, and I-OD. The retinal displacement, macular hole closure rate, and best corrected visual acuity (BCVA) were compared between the two groups after surgery. RESULTS: At postoperative 1, 3, and 6mo, the macula slipped toward the OD, manifested by the decreased T-OD, N-OD, S-OD, and I-OD (P<0.05). No significant difference was found in the T-OD, N-OD, S-OD, and I-OD between N-T group and T-N group. IMH closure rate was 100% both in N-T group and T-N group. There was no significant difference in BCVA between two groups (P<0.05). CONCLUSION: The macula slips toward the OD after successful macular hole surgery. The two different ILM peeling pattern show similar visual outcome and retinal displacement, which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.

scholarly journals Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling

Eye ◽  
2013 ◽  
Vol 27 (7) ◽  
pp. 871-877 ◽  
Author(s):  
K Kawano ◽  
Y Ito ◽  
M Kondo ◽  
K Ishikawa ◽  
S Kachi ◽  
...  
Keyword(s):  
Macular Hole ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Macular Hole Surgery ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling
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