Relationship of Dissociated Optic Nerve Fiber Layer Appearance to Internal Limiting Membrane Peeling

Mitamura, Yoshinori; Ohtsuka, Kenji

doi:10.1016/j.ophtha.2005.04.026

Cited by 136 publications

(146 citation statements)

References 10 publications

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“…The present study had a higher detection rate of postoperative DONFL than previous studies [10,11,14]. The incidence of DONFL in ILM-peeled eyes after idiopathic MH surgery on color fundus photography and blue-filter fundus photography was previously reported to be 54 and 62%, respectively, whereas the incidence in our study was 69.2% on color fundus photography, 88.5% on cross-sectional images, and 84.6% on retinal surface images obtained using SD-OCT at 6 months after surgery.…”

Section: Discussioncontrasting

confidence: 58%

“…In previous studies [10,11,14], dimples were observed in the RNFL corresponding to each stria of the DONFL and the dimple depths were limited to the RNFL thickness. In that study, the postoperative incidence of DONFL appearance was analyzed with a fundus photograph, and the morphological characteristics of DONFL were analyzed with a relatively small number of cases using time domain OCT.…”

Section: Introductionmentioning

confidence: 98%

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Morphological Change of Inner Retinal Layer on Spectral-Domain Optical Coherence Tomography following Macular Hole Surgery

Kim

et al. 2013

Ophthalmologica

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Background/Aims: To investigate the morphological changes of the inner retinal layer by spectral-domain optical coherence tomography (OCT) after idiopathic full-thickness macular hole (MH) surgery. Methods: In a retrospective study, the authors evaluated 52 eyes of 49 patients with MH closed following vitrectomy. All patients were followed postoperatively for more than 6 months. Cross-sectional and retinal surface images were obtained using Cirrus high-definition OCT before and after surgery. In 24 of the 52 eyes, fundus autofluorescence (FAF) was analyzed. Results: The incidence of dissociated optic nerve fiber layer (DONFL) increased gradually over time after surgery. 57.7% had defects of only the retinal nerve fiber layer (RNFL) and 30.8% had defects in the inner plexiform layer at 6 months after surgery. Postoperative best-corrected visual acuity did not differ significantly based on the depth of the DONFL (p = 0.299). There were no changes in FAF in the area with DONFL. Conclusions: DONFL is characterized by progressive defects that are not limited to RNFL thickness. The healing process after vitrectomy for MH is not limited in the RNFL affecting deeper structural changes. Further investigations are required to evaluate the pathophysiological mechanism of inner retinal change after MH surgery.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 98%

Morphological Change of Inner Retinal Layer on Spectral-Domain Optical Coherence Tomography following Macular Hole Surgery

Kim

et al. 2013

Ophthalmologica

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“…A clinicopathological study correlated retinal cell fragments of large size, namely retinal cell fragments of more than 2 μm in diameter, on the removed ILM with changes in macular dysfunction on the multifocal ERG [59] . This study suggested that large cell fragments on the retinal side of the ILM are related to Müller cell damage with transient alterations of retinal Color version available online [54][55][56] . However, Mitamura and Ohtsuka [56] did not find any significant difference between the zone of DONFL appearance and normal retina concerning the microperimetry threshold values, suggesting there was no loss of optic nerve fibers.…”

Section: Retinal Function and Chromovitrectomymentioning

confidence: 88%

“…This study suggested that large cell fragments on the retinal side of the ILM are related to Müller cell damage with transient alterations of retinal Color version available online [54][55][56] . However, Mitamura and Ohtsuka [56] did not find any significant difference between the zone of DONFL appearance and normal retina concerning the microperimetry threshold values, suggesting there was no loss of optic nerve fibers. With regard to dye assistance in ILM removal, Christensen et al [61] reported on the same incidence of DONFL appearance in ICG-peeled and TB-peeled eyes, suggesting that the surgical procedure itself was responsible for this clinical feature after ILM removal.…”

Section: Retinal Function and Chromovitrectomymentioning

confidence: 88%

“…However, subtle functional and morphological alterations were infrequently observed following macular surgery with ILM peeling, including changes of the focal macular electroretinogram (ERG) [53] , dissociated optic nerve fiber layer (DONFL) appearance [54][55][56] , paracentral scotomata or visual field defects [57,58] .…”

Section: Retinal Function and Chromovitrectomymentioning

confidence: 99%

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Chromovitrectomy and the Vitreoretinal Interface

Schumann¹,

Haritoglou²

2013

Ophthalmologica

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It still remains unclear to which extent the presence and the amount of retinal debris seen in internal limiting membrane (ILM) specimens harvested during macular surgery for macular holes or epiretinal membranes are related to the procedure of ILM peeling itself or to modifications of the surgical technique, such as application of vital dyes for visualization of the ILM, or to pathological conditions with epiretinal membrane formation at the vitreoretinal interface. The presence of cellular fragments on the retinal side of the removed ILM appears to be of multifactorial origin, and additional causes besides dye application need to be considered. However, morphological studies with evaluation of vital dyes are still of relevance and provide additional insights into the ultrastructure of the vitreoretinal interface and its interaction with adjuvants used during macular surgery. Chromovitrectomy is an emerging field in vitreoretinal surgery. It is of importance to better understand the tissue-dye interactions, which not only alter the mechanical properties of the tissue being stained, but may also have an impact on the functional result postoperatively.

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