Demirel Sibel, Abdullayev Ahmed, Yanık Özge, Batıoğlu Figen, Özmert Emin
Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
Turk J Ophthalmol. 2017 Jun;47(3):138-143. doi: 10.4274/tjo.34545. Epub 2017 Jun 1.
To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness after vitrectomy with internal limiting membrane (ILM) peeling for idiopathic macular holes using spectral domain optical coherence tomography (SD-OCT).
Eighteen eyes of 18 patients with unilateral idiopathic macular hole who underwent vitrectomy with ILM peeling were retrospectively analyzed. Healthy fellow eyes of the patients and 18 eyes of 18 age-matched healthy individuals constituted the control group. The patients were evaluated at 1 day, 1 week, 1 month, and 3 months after surgery. The best corrected visual acuity (BCVA) measurements, biomicroscopic examination findings and SD-OCT measurements were recorded. Ganglion cell-inner plexiform layer thickness was evaluated with ganglion cell analysis software of Cirrus HD-OCT before surgery and at 1 month and 3 months after surgery and compared with control groups. Presence of dissociated optic nerve fiber layer (DONFL) was evaluated with C-scan mode.
Of the 18 patients, 9 were male and 9 were female with a mean age of 65.6±5.6 (55-77) years. Preoperative BCVA was 0.75±0.19 logMAR, while it was 0.44±0.17 logMAR and 0.36±0.15 logMAR at postoperative 1 and 3 months, respectively (p<0.001). Postoperative mean GCIPL thickness was 66.33±17.28 µm. There was a correlation between mean GCIPL thickness and BCVA at postoperative 3 months (p<0.01). When compared with the control group, GCIPL thickness was significantly thinner in all quadrants of all patients at postoperative 3 months. Dissociated optic nerve fiber layer appearance was observed on C-scan in 13 of 18 eyes postoperatively. There was no correlation between the presence of DONFL and BCVA (p>0.05).
Internal limiting membrane peeling during macular hole surgery may cause functional and/or structural changes that may be associated with visual acuity. Significant GCIPL thinning and DONLF appearance may occur postoperatively.
使用频域光学相干断层扫描（SD-OCT）评估特发性黄斑裂孔玻璃体切除联合内界膜（ILM）剥除术后黄斑视网膜神经节细胞-内丛状层（GCIPL）厚度。
回顾性分析18例单侧特发性黄斑裂孔患者接受玻璃体切除联合ILM剥除术的18只眼。患者的健侧眼及18例年龄匹配的健康个体的18只眼组成对照组。在术后1天、1周、1个月和3个月对患者进行评估。记录最佳矫正视力（BCVA）测量值、生物显微镜检查结果和SD-OCT测量值。术前及术后1个月和3个月使用Cirrus HD-OCT的神经节细胞分析软件评估神经节细胞-内丛状层厚度，并与对照组进行比较。使用C扫描模式评估有无视神经纤维层分离（DONFL）。
18例患者中，男性9例，女性9例，平均年龄65.6±5.6（55 - 77）岁。术前BCVA为0.75±0.19 logMAR，术后1个月和3个月分别为0.44±0.17 logMAR和0.36±0.15 logMAR（p<0.001）。术后平均GCIPL厚度为66.33±17.28 µm。术后3个月平均GCIPL厚度与BCVA之间存在相关性（p<0.01）。与对照组相比，所有患者术后3个月所有象限的GCIPL厚度均明显变薄。术后18只眼中有13只眼在C扫描上观察到视神经纤维层分离外观。DONFL的存在与BCVA之间无相关性（p>0.05）。
黄斑裂孔手术中内界膜剥除可能导致与视力相关的功能和/或结构变化。术后可能出现明显的GCIPL变薄和DONLF外观。
