Macular Displacement After Vitrectomy in Eyes With Idiopathic Macular Hole Determined by Optical Coherence Tomography Angiography

Akahori, Tomohiko; Iwase, Takeshi; Yamamoto, Kentaro; Ra, Eimei; Kawano, Kenichi; Ito, Yasuki; Terasaki, Hiroko

doi:10.1016/j.ajo.2018.02.021

Cited by 37 publications

(45 citation statements)

References 26 publications

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“…The substantial equivalence of the two groups with regard to the parafoveal macular area thickness (MT), which includes all the neural retina layers, and the inner 3-mm parafoveal area including ILM, GCL++ seems to deny difference in toxicity from the two dyes by SS-OCT evaluation at this level. The thinning of the outer 6-mm GCL++ area from 6 to 12 months in all sectors in both groups is in agreement with literature data, since, as described in the introduction, thinning of the inner retina, including GCL++ and RNFL, after ILM peeling has been described both with ICG and BBG in SD-OCT-based studies [24,[30][31][32][33]. In our patients, we must at first note that in the majority of cases, as described in the surgical procedure section, ILM surgical manipulation began near the inferior or superior vascular arcade.…”

Section: Discussionsupporting

confidence: 91%

“…However, some experimental and clinical studies indicate a degree of toxicity from blue dyes in vitreoretinal interface and traditional macular hole surgery [24,[30][31][32]. Studies using spectral-domain (SD) OCT analysis point out postoperative thinning of the inner retinal layers after BBG-stained ILM peeling, mainly of the temporal macular ganglion cell and inner plexiform layer (GCL++) [30][31][32][33]. This seems indeed related surgical trauma and/or temporal thinning resulting from post-surgical nasal displacement of the fovea, without agreement on the influence of blue dye toxicity [32,33].…”

Section: Introductionmentioning

confidence: 99%

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Infracyanine Green vs. Brilliant Blue G in Inverted Flap Surgery for Large Macular Holes: A Long-Term Swept-Source OCT Analysis

et al. 2020

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Background and Objectives: To compare the long-term toxicity of infracyanine green (IFCG) to brilliant blue G (BBG) in inverted internal limiting membrane flap surgery (I-ILMFS) for large, full-thickness macular holes (FTMHs). Materials and Methods: Prospective randomized study including 39 eyes with ≥ 400 µm idiopathic FTMH who underwent I-ILMFS with either IFCG or BBG. Postoperative 6- and 12-month corrected distance visual acuity (CDVA), closure rate, and swept-source optical coherence tomography parameters, including ellipsoid zone (EZ) and external limiting membrane (ELM) mean defect length, central foveal thicknesses (CFT), parafoveal macular thickness (MT), ganglion cells and inner plexiform layer (GCL++) thickness, and peripapillary nerve fiber layer (pRNFL) thickness, were compared. Results: Nineteen eyes were included in the IFCG group and 20 eyes in the BBG group. In all cases a FTMH closure was found. CDVA improved at 6 and 12 months in both groups (p < 0.0005); the increase at 12 months was greater in the BBG group (p = 0.036). EZ and ELM defects did not differ between groups at either follow-up time. CFT at 12 months was greater in the BBG group (p = 0.041). A 12-months compared to 6-months MT decrease was present in both groups (p < 0.01). The GCL++ superior inner sector was thicker in the BBG group at 12 months (p = 0.036), as were the superior outer sector (p = 0.039 and p = 0.027 at 6 and 12 months, respectively) and inferior outer sector (p = 0.011 and p = 0.009 at 6 and 12 months, respectively). Conclusion: In our study BBG in I-ILMFS exhibits better long-term CDVA and retinal thickness than does IFCG, suggesting a lesser toxicity from BBG. These findings support the use of BBG over IFCG in I-ILMFS.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Infracyanine Green vs. Brilliant Blue G in Inverted Flap Surgery for Large Macular Holes: A Long-Term Swept-Source OCT Analysis

et al. 2020

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“…We obtained the 3 × 3 mm en face images of the microvasculature in the macular region using the Angioplex (Zeiss Meditec. Inc, Germany) OCTA device 16 . The images of the superficial capillary network layer were used to measure the displacements of the retina and the area of the foveal avascular zone (FAZ; Fig.…”

Section: Subjectsmentioning

confidence: 99%

Association between displacement and thickness of macula after vitrectomy in eyes with epiretinal membrane

Momota

Iwase

Akahori

et al. 2020

Sci Rep

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the purpose of this cross-sectional retrospective study was to determine the relationship between the retinal displacements and the retinal thickness in eyes with epiretinal membrane (eRM) after vitrectomy with internal limiting membrane (iLM) peeling. to accomplish this, we measured the retinal thickness using optical coherence tomography (oct) and the retinal displacement using OCT angiography to obtain 3 mm × 3 mm en face images before, and 2, 4, and 8 weeks following the surgery from 20 eyes of 20 patients. The distance between the retinal vessel bifurcations and the fovea was significantly displaced centrifugally and asymmetrically in the 4 quadrants postoperatively (P < 0.001). The foveal avascular zone (FAZ) was significantly enlarged, and the central foveal thickness (CFT) and the inner nuclear layer (INL) thickness were significantly thinner postoperatively. The displacements were significantly correlated with the changes in the FAZ area (r = 0.717, P < 0.001), the CFT (r = − 0.702, P < 0.001), and the INL thickness (r = − 0.702, P < 0.001). In conclusion, the distance between the retinal bifurcations and the fovea was asymmetrically expanded after the surgery and was significantly correlated with the morphological changes. These results indicate that a horizontal macular contraction is correlated with vertical retinal contraction in the eyes with an eRM. An idiopathic epiretinal membrane (ERM) is a relatively common retinochoroidal disorder in older individuals 1,2 , and it can cause an inner retinal displacement of the macula area and a disruption of the foveal structure 3. These alterations cause traction on the retina in the macular area which can lead to visual dysfunction and metamorphopsia. Vitrectomy and removal of the ERM with or without internal limiting membrane (ILM) peeling is used to release the traction and is effective in improving the visual dysfunction, metamorphopsia, and visual acuity 4-6. Thus, it is important to know how the retina in the macular area is displaced in more detail after the surgery because the displacement will affect the visual function. Optical coherence tomography (OCT) enables clinicians to obtain information of the microstructures of the fovea, and earlier studies have reported that the retinal layer at the fovea is thickened and the outer retinal layers are disrupted in eyes with an ERM 7-9. The integrity of the outer retinal layers is important for vision in retinochoroidal disorders, and their alterations have been evaluated 10-12. However, there have been only a few reports on the changes of the inner retinal layers in eyes with ERM after surgery 13. This is important because the integrity of the inner retina is a major determinant of the visual dysfunctions in eyes with an ERM. OCT angiography (OCTA) is a noninvasive and safe technique that can obtain images of the microvasculature of the retina and the choroid. OCTA has enabled clinicians to investigate the retinal vasculature in situ repeatedly in short intervals 14,15. The displacements of the inner retin...

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“…[10][11][12][13]25 Due to this mechanism, OCTA studies showed that FAZ area was significantly decreased after surgery compared with the preoperative FAZ area. [11][12][13] However, it was still unknown whether FAZ area would change after MH closure. In this study, we showed that once the FAZ area decreases along with MH closure, it thereafter increases toward the normal value over time.…”

Section: Discussionmentioning

confidence: 99%

Visual Acuity Recovery After Macular Hole Closure Associated With Foveal Avascular Zone Change

Tsuboi

Fukutomi

Sasajima

et al. 2020

Trans. Vis. Sci. Tech.

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To evaluate changes in the foveal avascular zone (FAZ) area during the postoperative period of macular hole (MH) surgery using the optical coherence tomography angiography (OCTA) and to investigate its relationship to visual acuity (VA). Methods: Consecutive unilateral MH patients who underwent successful MH closure with at least a six-month observation period were studied retrospectively. To evaluate the FAZ area, OCTA images were obtained at the preoperative visit, the first postoperative visit, and the six-month visit. Main outcome measures were postoperative FAZ change and its relationship to VA change after MH closure. Results: Fifty-one cases were studied. The FAZ area was 0.42 ± 0.11 mm 2 at the preoperative visit, 0.25 ± 0.091 mm 2 at the first postoperative visit and 0.31 ± 0.11 mm 2 at the six-month visit. FAZ area at the first postoperative visit was significantly smaller (P < 0.0001) than at the preoperative visit. FAZ area at the six-month visit was significantly greater (P < 0.0001) than at the first postoperative visit, but still significantly smaller (P = 0.0002) compared to the normal fellow eye. The postoperative FAZ area enlargement from the first postoperative visit to the six-month visit was significantly correlated with the postoperative VA recovery (P = 0.0322) and the postoperative photoreceptor reconstruction (P = 0.0213). Conclusions: The FAZ area once decreases along with MH closure; it thereafter increases toward the normal value over time. The postoperative FAZ change was correlated with the VA recovery. Translational Relevance: This study suggests that the postoperative FAZ area enlargement might be a potential biomarker indicating foveal reconstruction after MH closure.

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Macular Displacement After Vitrectomy in Eyes With Idiopathic Macular Hole Determined by Optical Coherence Tomography Angiography

Cited by 37 publications

References 26 publications

Infracyanine Green vs. Brilliant Blue G in Inverted Flap Surgery for Large Macular Holes: A Long-Term Swept-Source OCT Analysis

Infracyanine Green vs. Brilliant Blue G in Inverted Flap Surgery for Large Macular Holes: A Long-Term Swept-Source OCT Analysis

Association between displacement and thickness of macula after vitrectomy in eyes with epiretinal membrane

Visual Acuity Recovery After Macular Hole Closure Associated With Foveal Avascular Zone Change

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