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

Abstract

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.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Vitreo SURG

DOI:10.5301/ejo.5001066

Authors

Mun Y. Faria, Nuno P. Ferreira, Sofia Mano, Diana M. Cristóvao, David C. Sousa, Manuel E. Monteiro-Grillo

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Hospital Santa Maria, Centro de Estudos das Ciências da Visão, Faculdade de Medicina, Universidade de Lisboa, Lisbon - Portugal
  • Ophthalmology Department, Hospital Santa Maria, Lisbon - Portugal
  • University Ophthalmology Clinic, Faculty of Medicine, University of Lisbon, Lisbon - Portugal
  • Ophthalmology Department, Instituto de Oftalmologia Dr Gama Pinto, Lisbon - Portugal

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