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KMID : 1151620170020020083
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Journal of Retina
2017 Volume.2 No. 2 p.83 ~ p.90
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Topographic Changes in the Macula after Closure of Idiopathic Macular Hole without Internal Limiting Membrane Peeling
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Kwon Han-Jo
Park Sung-Who
Lee Ji-Eun
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Abstract
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Purpose: To compare topographic changes in the macula after closure of idiopathic macular hole both with and without internal limiting membrane peeling.
Methods: This study enrolled patients with stage 2 idiopathic macular hole with a diameter less than 300 μm who had undergone vitrectomy for macular hole closure from January 2012 to January 2016: four eyes of four patients (group 1) without internal limiting membrane peeling and 16 eyes of 16 patients (group 2) with internal limiting membrane peeling. A custom program was developed to analyze displacement of retinal vessels in the macula. The grid comprised two concentric rings of different sizes, each containing eight sectors, and displacement of retinal vessels in each sector was compared. Mean vector distance and angle of retinal vascular displacement of each zone (medial, lateral, superior, and inferior) was calculated from the combination of each sector and compared between the two groups.
Results: Preoperative mean macular hole diameter in groups 1 and 2 was 218.8 ± 38.9 μm, and 218.6 ± 38.1 μm, respectively (p 〉 0.05). The average displacement distance of retinal vessels in group 1 was 3.4 μm with 38.7° from the posterior pole, while the inner and outer concentric rings barely moved (5.5 μm, and 1.4 μm, respectively). However, the average displacement distance of retinal vessels in group 2 was 45.9 μm with 0.9° from the posterior pole, and the inner (59.0 μm, 2.8°) and outer rings (32.9 μm, -2.4°) shifted to the nasal side. Retinal vascular displacement appeared to be significantly lower in the group without internal limiting membrane peeling compared to the group with internal limiting membrane peeling.
Conclusions: Retinal vascular displacement is minimal after vitrectomy without internal limiting membrane peeling in cases of small macular hole, which supports the hypothesis of previous studies that the internal limiting membrane contributes to structural maintenance of the macula and inhibits macular displacement.
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KEYWORD
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Internal limiting membrane, Macular hole, Topographic change
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