Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling

Abstract

Purpose To determine whether there is a displacement of the fovea toward the optic disc after successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling. Methods The medical records of 54 eyes of 53 patients that had undergone pars plana vitrectomy with ILM peeling and gas or air tamponade for an idiopathic MH were evaluated. Spectral-domain optical coherence tomography (OCT) had been performed before and 46 months after the surgery. The preoperative distances between the center of the MH and the optic disc (MH-OD), center of the MH and the bifurcation or crossing of retinal vessels (MH-RV) were measured in the OCT images. In addition, the postoperative distance between the center of the fovea and optic disc (F-OD) and the center of the fovea and the same bifurcation or crossing of retinal vessels (F-RV) were measured in the OCT images. Results The F-OD was 2.67 ± 0.33 disc diameters (DD), which was significantly shorter than that of the MH-OD of 2.77 ± 0.33 DD (Po0.001). The F-RV was also significantly shorter than the MH-RV on the inner nasal area (from 0.85 ± 0.16DD to 0.79 ± 0.15DD; Po0.001), the inner temporal area (from 0.82±0.15DD to 0.77±0.14DD; Po0.001), and outer nasal area (from 1.70 ± 0.31DD to 1.65 ± 0.32DD; Po0.001), but it was significantly longer than the MH-RV in the outer temporal area (from 1.65±0.29DD to 1.68±0.29DD; Po0.001).Conclusion Our results showed that successful closure of a MH by vitrectomy with ILM peeling and gas tamponade leads to a displacement of the center of the macula toward the optic disc.

Asymmetrical steepening of the foveal contour after macular hole surgery with internal limiting membrane peeling

“…We reported that the parafoveal retinal thickness was asymmetrical, e.g., thicker nasal retina and thinner temporal one [12,13]. Kawano et al showed a displacement of the fovea toward the optic disc after PPV with ILM peeling [17]. This displacement was confirmed by other studies [18,19].…”

“…Kawano et al and others reported that there was a shortening of the disc-to-fovea distance after MH surgery [17][18][19]. Therefore, we examined whether this change was related to the shape of the fovea.…”

Temporal changes in foveal contour after macular hole surgery

“…[12][13][14] Alterations in the retinal microstructure and structural stability due to ILM peeling have been postulated as a reason for nasal displacement of retina after MH surgery with ILM peeling. [15][16][17][18] The changes in retinal microstructure found in our study may also be partially caused by an alteration in structural stability due to ILM peeling. The frequency of the notching of tissue as well as the amount of foveal tissue elongation were relatively greater in the nasal direction, suggesting these phenomena may have some association with nasal displacement of the retina, as was reported in previous studies.…”

Foveal Pseudoectopıa: Report of A Case and Review of the Literature

“…These cases were presumably congenital and developmental anomalies. Foveal displacement may be associated with intraocular surgeries such as retinal detachment or macular hole surgeries [6][7][8] . In a study performed Kawano et al [8] after vitrectomy with ILM peeling for macular hole, fovea of the patients displaced toward the optic disc.…”

“…Foveal displacement may be associated with intraocular surgeries such as retinal detachment or macular hole surgeries [6][7][8] . In a study performed Kawano et al [8] after vitrectomy with ILM peeling for macular hole, fovea of the patients displaced toward the optic disc. Displacement of the macula was also reported in cases with epiretinal membrane and epiretinal membrane peeling surgeries [9,10] .…”