Dissociated Optic Nerve Fiber Layer Appearance after Internal Limiting Membrane Peeling for Idiopathic Macular Holes

Ito, Yasuki; Terasaki, Hiroko; Takahashi, Akiko; Yamakoshi, Takehiro; Kondo, Mineo; Nakamura, Makoto

doi:10.1016/j.ophtha.2005.02.023

Cited by 193 publications

(201 citation statements)

References 22 publications

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“…A clinicopathological study correlated retinal cell fragments of large size, namely retinal cell fragments of more than 2 μm in diameter, on the removed ILM with changes in macular dysfunction on the multifocal ERG [59] . This study suggested that large cell fragments on the retinal side of the ILM are related to Müller cell damage with transient alterations of retinal Color version available online [54][55][56] . However, Mitamura and Ohtsuka [56] did not find any significant difference between the zone of DONFL appearance and normal retina concerning the microperimetry threshold values, suggesting there was no loss of optic nerve fibers.…”

Section: Retinal Function and Chromovitrectomymentioning

confidence: 88%

“…However, subtle functional and morphological alterations were infrequently observed following macular surgery with ILM peeling, including changes of the focal macular electroretinogram (ERG) [53] , dissociated optic nerve fiber layer (DONFL) appearance [54][55][56] , paracentral scotomata or visual field defects [57,58] .…”

Section: Retinal Function and Chromovitrectomymentioning

confidence: 99%

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Chromovitrectomy and the Vitreoretinal Interface

Schumann¹,

Haritoglou²

2013

Ophthalmologica

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It still remains unclear to which extent the presence and the amount of retinal debris seen in internal limiting membrane (ILM) specimens harvested during macular surgery for macular holes or epiretinal membranes are related to the procedure of ILM peeling itself or to modifications of the surgical technique, such as application of vital dyes for visualization of the ILM, or to pathological conditions with epiretinal membrane formation at the vitreoretinal interface. The presence of cellular fragments on the retinal side of the removed ILM appears to be of multifactorial origin, and additional causes besides dye application need to be considered. However, morphological studies with evaluation of vital dyes are still of relevance and provide additional insights into the ultrastructure of the vitreoretinal interface and its interaction with adjuvants used during macular surgery. Chromovitrectomy is an emerging field in vitreoretinal surgery. It is of importance to better understand the tissue-dye interactions, which not only alter the mechanical properties of the tissue being stained, but may also have an impact on the functional result postoperatively.

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Section: Retinal Function and Chromovitrectomymentioning

confidence: 88%

Section: Retinal Function and Chromovitrectomymentioning

confidence: 99%

Chromovitrectomy and the Vitreoretinal Interface

Schumann¹,

Haritoglou²

2013

Ophthalmologica

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“…[7][8][9][10][11][12][13][14][15] Removal of ILM is known to cause mechanical trauma to the retinal nerve fiber layer (RNFL) but the observed changes seem to be subclinical. [25][26][27][28][29] Early transient swelling of the arcuate RNFL 30 and dissociated optic nerve fiber layer [31][32][33] have been reported to occur after ILM peeling but they do not appear to influence the visual recovery or to cause reduced retinal sensitivity. [30][31][32][33][34] However, it has been postulated that ILM peeling may be related to selective superotemporal, temporal, and inferotemporal RNFL thickness reduction and retinal weakening caused by Müller cell damage, which can result in paracentral hole formation.…”

Section: Discussionmentioning

confidence: 99%

The role of membrane-inner retina adherence in predicting simultaneous internal limiting membrane peeling during idiopathic epiretinal membrane surgery

Tranos

Wickham

Dervenis

et al. 2016

Eye

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Purpose To correlate the frequency and extent of simultaneous inadvertent internal limiting membrane (ILM) peeling during idiopathic epiretinal membrane (ERM) removal with characteristics of ERM adherence demonstrated on pre-operative spectral domain optical coherence tomography (SD-OCT). Patients and methods This is a prospective, observational, case series of patients undergoing pars plana vitrectomy for idiopathic ERM. Inner retina-ERM adhesion was categorized as focal, broad or complete in five anatomic locations at macular area based on preoperative SD-OCT findings. The extent of spontaneous ILM peeling was quantified on a scale 0-100% in each of the aforementioned anatomic locations by the operating surgeons who were masked to the OCT characteristics. All operations were recorded with a high definition recording system and the area of simultaneous ILM peel was quantified by a second masked observer. The final extent of spontaneous ILM peel was calculated as the average of the two scores. Results Thirty consecutive subjects who underwent surgery for idiopathic ERM were included in the study. Evidence of simultaneous ILM peeling was identified in 80.3% of individuals. With regards to the type of ERM-macula adhesion, inadvertent ILM peel was observed in 70% of the patients who pre-operatively showed complete adhesion, in 43% with broad adhesion and in only 21% with focal adhesion (Po0.001). The extent of the spontaneous ILM peel during removal of ERM was also significantly dependent on the type of ERM-inner retina adhesion. Total simultaneous ILM peel was observed in 59% of locations with complete ERM-macula adhesion but only in 22% and 7% of locations with broad and focal adhesion respectively (Po0.001). Conclusions Simultaneous ILM peel is a frequent occurrence during ERM surgery, especially when there is complete or broad ERM adherence to the macula. The type of ERM-inner retina adhesion represents a valid predictor of the extent of simultaneous ILM peel during removal of ERM. Thorough evaluation of preoperative OCT may be a useful tool in determining a safer, more simplistic strategy in ERM surgery.

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“…Although peeling of the ILM has been postulated to facilitate the closure of the MH by removing a possible source of contractile force, [9][10][11] possible negative influence of ILM peeling has also been suggested. [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.…”

Section: Discussionmentioning

confidence: 99%