Faria Mun Y, Ferreira Nuno P, Mano Sofia, Cristóvao Diana M, Sousa David C, Monteiro-Grillo Manuel E
1 Hospital Santa Maria, Centro de Estudos das Ciências da Visão, Faculdade de Medicina, Universidade de Lisboa, Lisbon - Portugal.
3 University Ophthalmology Clinic, Faculty of Medicine, University of Lisbon, Lisbon - Portugal.
Eur J Ophthalmol. 2018 May;28(3):311-316. doi: 10.5301/ejo.5001066. Epub 2017 Oct 16.
To provide a spectral-domain optical coherence tomography (SD-OCT)-based analysis of retinal layers thickness and nasal displacement of closed macular hole after internal limiting membrane peeling in macular hole surgery.
In this nonrandomized prospective interventional study, 36 eyes of 32 patients were subjected to pars plana vitrectomy and 3.5 mm diameter internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH). Nasal and temporal internal retinal layer thickness were assessed with SD-OCT. Each scan included optic disc border so that distance between optic disc border and fovea were measured.
Thirty-six eyes had a successful surgery with macular hole closure. Total nasal retinal thickening (p<0.001) and total temporal retinal thinning (p<0.0001) were observed. Outer retinal layers increased thickness after surgery (nasal p<0.05 and temporal p<0.01). Middle part of inner retinal layers (mIRL) had nasal thickening (p<0.001) and temporal thinning (p<0.05). The mIRL was obtained by deducting ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness from overall thickness of the inner retinal layer. Papillofoveal distance was shorter after ILM peeling in macular hole surgery (3,651 ± 323 μm preoperatively and 3,361 ± 279 μm at 6 months; p<0.0001).
Internal limiting membrane peel is associated with important alteration in inner retinal layer architecture, with thickening of mIRL and shortening of papillofoveal distance. These factors may contribute to recovery of disrupted foveal photoreceptor and vision improvement after IMH closure.
提供基于光谱域光学相干断层扫描（SD-OCT）的黄斑裂孔手术中内界膜剥除术后视网膜各层厚度及黄斑中心凹鼻侧移位情况的分析。
在这项非随机前瞻性干预研究中，32例患者的36只眼因特发性黄斑裂孔接受了玻璃体切割术及直径3.5 mm的内界膜（ILM）剥除术。采用SD-OCT评估鼻侧和颞侧视网膜内层厚度。每次扫描均包括视盘边界，以便测量视盘边界与黄斑中心凹之间的距离。
36只眼手术成功，黄斑裂孔闭合。观察到鼻侧视网膜总厚度增加（p<0.001），颞侧视网膜总厚度变薄（p<0.0001）。术后外层视网膜厚度增加（鼻侧p<0.05，颞侧p<0.01）。视网膜内层中部（mIRL）鼻侧增厚（p<0.001），颞侧变薄（p<0.05）。mIRL通过从视网膜内层总厚度中减去神经节细胞层（GCL）和视网膜神经纤维层（RNFL）厚度获得。黄斑裂孔手术中ILM剥除术后，视盘黄斑距离缩短（术前为3651±323μm，6个月时为3361±279μm；p<0.0001）。
内界膜剥除与视网膜内层结构的重要改变有关，表现为mIRL增厚和视盘黄斑距离缩短。这些因素可能有助于特发性黄斑裂孔闭合后受损的黄斑光感受器恢复及视力改善。
