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

Faria, Mun Yueh; Ferreira, Nuno Pinto; Mano, Sofia; Cristóvão, Diana; Sousa, David Cordeiro; Monteiro-Grillo, Manuel E

doi:10.5301/ejo.5001066

Cited by 15 publications

(7 citation statements)

References 22 publications

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“…As a possible explanation, the authors hypothesized that, after ILM peeling, inner retinal cells were particularly affected by local inflammation, microcirculatory ischemia, and stretching effects [27]. The same group found a shortening of papillofoveal distance and thickening in the outer retinal layers (ORLs) in both nasal and temporal regions during the follow-up [28].…”

Section: Inner Retinal Layersmentioning

confidence: 99%

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Cicinelli

Marchese

Bandello

et al. 2019

Journal of Ophthalmology

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Aim. To summarize the spectrum of optical coherence tomography (OCT) and OCT angiography (OCTA) features after full-thickness macular hole (MH) repair surgery. Methods. A PubMed engine search was carried out using the terms “Macular Hole,” “Optical Coherence Tomography,” and “Optical Coherence Tomography Angiography.” All reports published in English up to October 2018, irrespective of their publication status, were included. Tomographic signs analyzed were divided according to the involved portion of the retina in “inner retinal layers” and “external retinal layers.” Despite predominantly involving the inner retinal layers, cystoid macular edema (CME) has been treated as a separate entity. Finally, report on vessel density (VD) changes and the foveal avascular zone (FAZ) area modifications have been included. Results. Different clinical findings can be observed on OCT of patients who underwent MH repair surgery. There is general consent that retinal thinning involving primarily the retinal nerve fiber layer and the ganglion cell layer takes place after surgery. In the postoperative period, the outermost retinal layers get progressively restored. Persistent defects in the ellipsoid zone or in the external limiting membrane correlate with worse postoperative visual outcome. OCTA has globally demonstrated that eyes after MH closure show a reduction in macular and paramacular VD and smaller FAZ areas, compared with control or fellow eyes. Conclusion. Clinicians should be aware of the most common tomographic findings to properly manage each condition. In addition, significant advantages for the postoperative application of OCT and OCTA include noninvasiveness, rapid and simple execution, repeatability, and precise measurements.

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Section: Inner Retinal Layersmentioning

confidence: 99%

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Cicinelli

Marchese

Bandello

et al. 2019

Journal of Ophthalmology

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“…Modi et al 6 reported that a larger ILM peel area is associated with significant alteration in inner retinal architecture, causing the adverse functional outcomes after FTMH surgery. Other studies have also determined that minimizing the structural alterations of the inner retina would improve visual outcomes in patients undergoing FTMH surgery 7 , 8 . Therefore, the inner retinal layer (IRL) would be one of the important factors associated with the visual outcomes after FTMH surgery.…”

Section: Introductionmentioning

confidence: 99%

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

Lee

Kim

Song

et al. 2021

Sci Rep

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To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.

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“…Kumagai et al [24] found that after vitrectomy with ILM peeling, the thickness of retina was significantly decreased in the temporal region compared to the normal fellow eyes. Faria et al [25] found that RNFL thinkness was significantly decreased in the temporal region compared to the nasal region 6mo after ILM peeling. Sabater et al [26] reported a significant thinning of the ganglion cell-inner plexiform layer in the temporal quadrant of the macula at a 6-month follow-up after ILM peeling.…”

Section: Rnfl and Gcc Thicknessmentioning

confidence: 99%

Negative effects of enlarging internal limiting membrane peeling for idiopathic macular hole surgery

Nie¹,

Wang²,

Chen³

et al. 2022

Int J Ophthalmol

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AIM: To observe the effects of the different extents of internal limiting membrane (ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole (IMH). METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A (18 patients), with the peeling area within one-half of the optic disc macular distance as the radius; group B (18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity (BCVA), light-adaptive electroretinography, macular hole (MH) closure rate, central macular thickness (CMT), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study (ETDRS) ring] before and 1, 3, and 6mo after surgery. RESULTS: The closure rate was 94.4% (17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo (P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery (P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery (P=0.038). CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.

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

Cited by 15 publications

References 22 publications

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

Negative effects of enlarging internal limiting membrane peeling for idiopathic macular hole surgery

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