Morphologic features and evolution of inner retinal dimples on optical coherence tomography after internal limiting membrane peeling.

PURPOSE: To evaluate morphologic features and the evolution of inner retinal dimples using spectral domain optical coherence tomography after internal limiting membrane peeling. METHODS: A single-center retrospective study of spectral domain optical coherence tomography features in 43 eyes after full-thickness macular hole surgery with internal limiting membrane peeling without adjunctive internal limiting membrane staining. RESULTS: Postoperatively, a total of 210 dimples were noted in 37 eyes (86%), with a mean of 5.7 dimples per eye (median, 5; range, 1-20), most frequently located in the inferotemporal quadrant (n = 122, 58%, P < 0.0001). At initial detection, mean dimple dimensions were 199 µm wide (median, 183; range, 87-442 µm) and 19 µm deep (median, 17; range, 7-35 µm). During follow-up, mean maximum dimensions were 351 µm wide (median, 305; range, 219-494 µm) and 30 µm deep (median, 31; range, 15-55 µm). Dimple dimension reached a maximum at 12 months (median, 10; range, 2-22 months) followed by a modest decline. Mean preoperative and final postoperative visual acuity were 0.70 logMAR (median, 0.54; range, 0.09-1.4 logMAR) and 0.38 logMAR (median, 0.30; range, 0-1.4 logMAR), respectively. CONCLUSION: Inner retinal dimples are common after adjunct-free internal limiting membrane peeling and evolve in the postoperative period with enlargement over the first 12 months followed by reduction in size, and have no apparent impact on the visual acuity.

Size and vitreomacular attachment of primary full-thickness macular holes.

PURPOSE: To study the relationship between the size of primary full-thickness macular hole (MH) and the vitreomacular attachment status. DESIGN: Single-centre retrospective observational case series. METHODS: The records of 100 consecutive eyes operated for primary full-thickness MH were retrospectively reviewed. The vitreous status and MH diameter were assessed on the preoperative optical coherence tomography scans. MH were classified depending on the presence or absence of vitreomacular traction (VMT) and their size as small (<250 µm), medium (250-400 µm) and large (>400 µm), as suggested in the International VMT Study Group Classification. RESULTS: 22% of MH had VMT and 13% had both VMT and a diameter <400 µm. The MH diameter was not significantly different depending on the presence or absence of VMT (respectively, 339±134 and 423±191 µm (p=0.094)), with large overlap between groups. Small, medium and large MH were similarly distributed regardless of the presence or absence of VMT (p=0.69). CONCLUSIONS: Our series of 100 MH did not reveal any significant relationship between the MH size and the presence or absence of VMT. Only 13% of MH had VMT and a diameter <400 mm, then were eligible for intravitreal ocriplasmin as a possible treatment.