Ohta Kouichi, Sato Atsuko, Senda Nami, Fukui Emi
Department of Ophthalmology, Matsumoto Dental University, Nagano, Japan.
Clin Ophthalmol. 2018 Mar 16;12:503-510. doi: 10.2147/OPTH.S154394. eCollection 2018.
We have shown that the foveal contour was asymmetrical after idiopathic macular hole (MH) closure by pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. The purpose of this study was to determine whether these morphological changes differ in eyes after PPV without ILM peeling.
Ten eyes of 10 patients that underwent PPV without ILM peeling and 12 eyes of 11 patients with ILM peeling were studied. The MH in all eyes was <400 µm in diameter. Six months after the PPV, the macular thickness and foveal slope around the closed MH were determined by spectral-domain optical coherence tomography. The thickness of the ganglion cell complex was measured by another spectral-domain optical coherence tomography instrument >6 months after the surgery.
The mean parafoveal retinal thickness in the non-peeled group was 367.1 µm in the nasal (N), 353.0 µm in the temporal (T), 366.9 µm in the superior (S), and 357.3 µm in the inferior (I) sectors. The T, S, and I sectors were significantly thicker than the corresponding sectors in the ILM peeled group (=0.0008, 0.003, and 0.03, respectively). The mean ganglion cell complex was thicker not only in the N sector but also in the T sector in the non-peeled group. The mean retinal slopes in the non-peeled group (N, 40.2°; T, 37.6°; S, 41.2°; I, 39.5°) were flatter than those in the peeled group (N, 52.3°; T, 43.6°; S, 50.8°; I, 51.9°; =0.009, 0.09, 0.008, and 0.017, respectively).
The symmetrical fovea after MH surgery in the non-ILM peeled eyes indicates that the asymmetrical fovea after ILM peeling was probably due to the ILM peeling.
我们已经表明，在通过玻璃体切割联合内界膜（ILM）剥除术关闭特发性黄斑裂孔（MH）后，黄斑中心凹轮廓不对称。本研究的目的是确定在未进行ILM剥除的玻璃体切割术后，这些形态学变化在眼中是否有所不同。
研究了10例未进行ILM剥除的玻璃体切割术患者的10只眼和11例进行ILM剥除的患者的12只眼。所有眼中的MH直径均<400 µm。玻璃体切割术后6个月，通过光谱域光学相干断层扫描确定闭合的MH周围的黄斑厚度和黄斑中心凹斜率。在手术后>6个月，通过另一台光谱域光学相干断层扫描仪器测量神经节细胞复合体的厚度。
未剥除组中，鼻侧（N）旁中心凹视网膜平均厚度为367.1 µm，颞侧（T）为353.0 µm，上方（S）为366.9 µm，下方（I）为357.3 µm。T、S和I象限明显比ILM剥除组中的相应象限厚（分别为=0.0008、0.003和0.03）。未剥除组中，不仅N象限，而且T象限的神经节细胞复合体均较厚。未剥除组的平均视网膜斜率（N，40.2°；T，37.6°；S，41.2°；I，39.5°）比剥除组（N，52.3°；T，43.6°；S，50.8°；I，51.9°；分别为=0.009、0.09、0.008和0.017）更平缓。
未进行ILM剥除的眼中MH手术后黄斑中心凹对称，这表明ILM剥除后黄斑中心凹不对称可能是由于ILM剥除所致。
