En Face OCT Detects Preretinal Abnormal Tissues Before and After Internal Limiting Membrane Peeling in Eyes with Macular Hole

PurposeTo compare vitrectomy with and without internal limiting membrane (ILM) peeling in small idiopathic macular holes.MethodsRetrospective multicentre study including consecutive eyes with ≤250 μm idiopathic macular hole treated with vitrectomy. The primary outcome was hole closure rate. Best‐corrected visual acuity (BCVA) change, closure patterns on optical coherence tomography, rates of external limiting membrane (ELM) and ellipsoid zone (EZ) recovery, and rate of complications were also investigated.ResultsIn total, 693 eyes were included. Hole closure rate was 98% in the peeling and 85% in the no‐peeling group (p < 0.001). At 12 months, mean BCVA change was 0.38 ± 0.22 logMAR in the peeling and 0.45 ± 0.21 logMAR in the no‐peeling group (p = 0.02); 66% versus 80% of eyes had a U‐shaped morphology, respectively; EZ recovery rate was 75% and 93%, respectively (p = 0.02). In the no‐peeling group, eyes with a vitreomacular traction (VMT) showed a 96% closure rate, comparable to the peeling group (p = 0.40). The incidence of adverse events was similar except for dissociated optic nerve fibre layer (55% in the peeling vs. 9% in the no‐peeling group, p < 0.001).ConclusionsIn small idiopathic macular holes, ILM peeling provides a higher closure rate compared to no‐peeling; however, if a VMT is present closure rates are comparable. In closed macular holes, the no‐peeling technique provides advantages in terms of visual outcome and anatomical recovery.

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Non-Invasive Retinal Imaging Modalities for the Identification of Prognostic Factors in Vitreoretinal Surgery for Full-Thickness Macular Holes

Nicolosi

Vicini

Bacherini

et al. 2023

Diagnostics

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In this review, we will focus on different non-invasive retinal imaging techniques that can be used to evaluate morphological and functional features in full-thickness macular holes with a prognostic purpose. Technological innovations and developments in recent years have increased the knowledge of vitreoretinal interface pathologies by identifying potential biomarkers useful for surgical outcomes prediction. Despite a successful surgery of full-thickness macular holes, the visual outcomes are often puzzling, so the study and the identification of prognostic factors is a current topic of interest. Our review aims to provide an overview of the current knowledge on prognostic biomarkers identified in full-thickness macular holes by means of different retinal imaging tools, such as optical coherence tomography, optical coherence tomography angiography, microperimetry, fundus autofluorescence, and adaptive optics.

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En Face OCT Detects Preretinal Abnormal Tissues Before and After Internal Limiting Membrane Peeling in Eyes with Macular Hole

Cited by 4 publications

References 38 publications

Macular hole with epiretinal proliferation: diagnostic value of en-face optical coherence tomography and clinical characteristics

Macular hole with epiretinal proliferation: diagnostic value of en-face optical coherence tomography and clinical characteristics

Vitrectomy in Small idiopathic MAcuLar hoLe (SMALL) study: Internal limiting membrane peeling versus no peeling

Non-Invasive Retinal Imaging Modalities for the Identification of Prognostic Factors in Vitreoretinal Surgery for Full-Thickness Macular Holes

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