Tada Atsushi, Machida Shigeki, Hara Yuji, Ebihara Satoshi, Ishizuka Masahiko, Gonmori Mana
Department of Ophthalmology, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minamikoshiagya, Koshigaya, Saitama 343-8555, Japan.
J Ophthalmol. 2021 Oct 19;2021:4624164. doi: 10.1155/2021/4624164. eCollection 2021.
To determine the long-term changes of the thickness of each retinal layer following macular hole (MH) surgery combined with internal limiting membrane (ILM) peeling.
The medical records of 42 eyes of 42 patients (41 to 86 years of age) who underwent MH surgery with ILM peeling between February 2016 and October 2018 were reviewed. A single surgeon operated on all patients, and all were followed for at least 24 months postoperatively. Spectral-domain optical coherence tomography (OCT) was performed to obtain retinal thickness maps of the parafoveal region corresponding approximately to the ILM peeled area. Each retinal layer was automatically segmented by the embedded software, and thickness maps were constructed for the total retinal layer (TRL), inner RL (IRL), middle RL (MRL), and outer RL (ORL). The averaged value of each retinal layer thickness was analyzed in the temporal/upper, temporal/lower, nasal/upper, and nasal lower quadrants.
The TRL thickness was significantly decreased in the temporal areas postoperatively. The IRL thickness thinned progressively and significantly until 6 months without further thinning in the temporal quadrants. The MRL thickness of all areas was significantly thicker than the baseline values at 0.5 months and then gradually decreased in the temporal regions. However, the thickening in the nasal regions returned to the baseline values after 1.5 months. The ORL decreased transiently relative to the baseline values at 0.5 months in all areas.
The ILM peeling does not affect only the thickness of the inner retina but also the middle and outer retinae in the parafoveal region. The chronological changes of the thickness after surgeries varied among the retinal layers and macular regions.
确定黄斑裂孔（MH）手术联合内界膜（ILM）剥除术后各视网膜层厚度的长期变化。
回顾了2016年2月至2018年10月期间接受MH手术联合ILM剥除的42例患者（41至86岁）42只眼的病历。所有患者均由同一位外科医生手术，术后均随访至少24个月。采用频域光学相干断层扫描（OCT）获取大致对应于ILM剥除区域的黄斑旁区域的视网膜厚度图。各视网膜层由嵌入式软件自动分割，并构建全视网膜层（TRL）、内视网膜层（IRL）、中视网膜层（MRL）和外视网膜层（ORL）的厚度图。分析颞侧/上方、颞侧/下方、鼻侧/上方和鼻侧/下方象限各视网膜层厚度的平均值。
术后颞侧区域TRL厚度显著降低。IRL厚度在颞侧象限逐渐显著变薄，直至6个月后不再进一步变薄。所有区域的MRL厚度在术后0.5个月时均显著厚于基线值，然后在颞侧区域逐渐降低。然而，鼻侧区域在术后1.5个月时增厚恢复至基线值。所有区域的ORL在术后0.5个月时相对于基线值短暂降低。
ILM剥除不仅影响内视网膜厚度，还影响黄斑旁区域的中视网膜和外视网膜厚度。术后各视网膜层厚度的时间变化在视网膜层和黄斑区域之间有所不同。
