Displacement of fovea toward optic disk after macular hole surgery with internal limiting membrane peeling

Abstract

PurposeThe purpose of this study was to demonstrate a displacement of the foveal depression toward the optic disk after idiopathic macular hole (MH) surgery with internal limiting membrane (ILM) peeling.MethodsTwo patients with a unilateral MH developed an MH in the fellow eyes. Vitrectomy with ILM peeling was performed on the fellow eye to close the MH. Images of spectral-domain optical coherence tomography (SD-OCT) were used to measure the disk-to-fovea distances pre MH formation, after MH formation, and 6 months after the closure of the MH.ResultsThe disk-to-fovea distance was shorter at 6 months than after the development of the MH (4,109 µm and 4,174 µm in Case 1 and 4,001 µm and 4,051 µm in Case 2).ConclusionThese results indicate that the fovea moves nasally after the MH surgery with ILM peeling.

Automatic Determination of the Center of Macular Hole Using Optical Coherence Tomography En Face Images

“…Anatomical migration after MH surgery was reported recently [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Fundus photography and OCT revealed that the fovea was displaced to the optic disc following MH closure via vitrectomy with ILM peeling.…”

“…The center of the MH is a landmark for measuring the movement of the retina after surgery; therefore, it is crucial to identify it with high accuracy and reproducibility. However, at present, the center of the MH is mostly identified manually [ 9 , 10 , 11 , 12 , 13 ]. Therefore, we investigated whether it is feasible to determine MH center using an automated image analysis technique.…”

Macular morphometrics in foveal displacement following full thickness macular hole surgery

“…All the previous reports[ 1 2 3 4 5 6 ] have reported a nasal shift with the temporal retina being more relaxed as a possible explanation. We saw that there is a temporal shift in 25% of the eyes and hence there may be other unknown factors in the postoperative remodeling process.…”

“…[ 4 ] Ohta et al . [ 5 ] compared the site of the pre-opened MH with the center of the opened hole and the postoperative closed hole. It would be interesting to see if the center shifts upon hole opening towards the side with the longer or shorter segment and how it affects the postoperative shift of the closed hole.…”

“…The displacement of the fovea towards the optic disc after vitrectomy and internal limiting membrane (ILM) peeling for full-thickness macular holes (FTMHs) has been previously reported. [ 1 2 3 4 5 6 ]…”