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Three-Dimensional Quantitative Analysis of Internal Limiting Membrane Peeling Related Structural Changes in Retinal Detachment Repair.
Hsieh, Tzu-Han; Wang, Jia-Kang; Chen, Fang-Ting; Chen, Yun-Ju; Wang, Ling-Uei; Huang, Tzu-Lun; Chang, Pei-Yao; Hsu, Yung-Ray.
Afiliação
  • Hsieh TH; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan.
  • Wang JK; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology (J-K.W., F-T.C., Y-J.C., P-Y.C., Y-R.H.), National Taiwan University Hospital, Taipei, Taiwan; Department of Elec
  • Chen FT; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology (J-K.W., F-T.C., Y-J.C., P-Y.C., Y-R.H.), National Taiwan University Hospital, Taipei, Taiwan; National Taiwan Un
  • Chen YJ; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology (J-K.W., F-T.C., Y-J.C., P-Y.C., Y-R.H.), National Taiwan University Hospital, Taipei, Taiwan; National Taiwan Un
  • Wang LU; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan.
  • Huang TL; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Electrical Engineering (J-K.W., T-L.H., Y-R.H.), Yuan Ze University, Taoyuan, Taiwan.
  • Chang PY; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology (J-K.W., F-T.C., Y-J.C., P-Y.C., Y-R.H.), National Taiwan University Hospital, Taipei, Taiwan; National Taiwan Un
  • Hsu YR; From the Department of Ophthalmology (T-H.H., J-K.W., F-T.C., Y-J.C., L-U.W., T-L.H., P-Y.C., Y-R.H.), Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology (J-K.W., F-T.C., Y-J.C., P-Y.C., Y-R.H.), National Taiwan University Hospital, Taipei, Taiwan; National Taiwan Un
Am J Ophthalmol ; 269: 94-104, 2024 Aug 24.
Article em En | MEDLINE | ID: mdl-39187230
ABSTRACT

PURPOSE:

To assess macular microstructural changes associated with internal limiting membrane peeling (ILMP) using 3-dimensional optical coherence tomography (3D-OCT) in primary macula-off rhegmatogenous retinal detachment (RRD) repairs with vitrectomy and silicone oil (SO) tamponade.

DESIGN:

Retrospective, consecutive, interventional case series.

METHODS:

Setting:

Institutional practice. PATIENT POPULATION Patients who received primary RRD repair by a single experienced surgeon between January 2017 and December 2021. MAIN OUTCOME

MEASURES:

In the qualitative comparative analysis, the presence of macular changes among patients who underwent primary RRD repair with (21 eyes) or without ILMP (20 eyes) were observed. Subsequently, a detailed quantitative analysis of ILMP-related microstructural changes in 56 eyes using both 3D and 2D-OCT images were performed.

RESULTS:

In the qualitative comparative analysis, macular microstructural changes were observed in 95% of ILMP eyes and 5% of non-ILMP eyes (p < .001). In the quantitative analysis, 4 major macular microstructural changes were detected dimple (75%), dissociated nerve fiber layer (DONFL) (55%), ILM peeling edge thinning (IPET) (64%), and temporal macular groove (TMG) (23%). Dimples (n = 251, average 4.5 ± 5.8 per eye) could be further classified into type I (confined to the inner plexiform layer [IPL]; 73%) and type II (beyond IPL, 27%). The average depth of the deepest dimples was 58 ± 18 µm. The extent of IPET was 6.0 ± 3.7 clock hours. The average length of TMG was 1.8 ± 0.4 mm. Comparing to unoperated fellow eyes, the eyes after ILMP showed decreased inner temporal over nasal retinal thickness ratio (0.86 ± 0.07 versus 0.96 ± 0.03, p < .001), shorter disc-fovea distance (4.61 ± 0.32 µm versus 4.78 ± 0.37 µm, p = .041), and wider retinal vein trajectories (c' = 2.48 ± 0.84 vs 3.39 ± 1.61, p = .002).

CONCLUSIONS:

Macular microstructural changes are common after ILMP in RRD repair, encompassing both focal changes (dimples, DONFL) and zonal changes (IPET, TMG). DONFL and dimples may be part of a continuum of findings stemming from the same mechanism. IPET and TMG are the results of macular tissue shift due to contracture of the optic disc and neurovascular bundle.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Am J Ophthalmol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Taiwan País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Am J Ophthalmol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Taiwan País de publicação: Estados Unidos