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Eur J Ophthalmol ; 28(3): 311-316, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29108397

RESUMEN

PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.


Asunto(s)
Membrana Basal/cirugía , Membrana Epirretinal/cirugía , Retina/patología , Perforaciones de la Retina/cirugía , Vitrectomía , Anciano , Femenino , Fóvea Central , Humanos , Masculino , Persona de Mediana Edad , Disco Óptico , Tamaño de los Órganos , Estudios Prospectivos , Retina/diagnóstico por imagen , Perforaciones de la Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Vitrectomía/métodos
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