Foveola nonpeeling internal limiting membrane surgery to prevent inner retinal damages in early stage 2 idiopathic macula hole

Ho, Tzyy‐Chang; Yang, Chung-May; Huang, Jen-Shang; Yang, Chang‐Hao; Chen, Muh‐Shy

doi:10.1007/s00417-014-2613-7

Cited by 32 publications

(58 citation statements)

References 32 publications

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“…Preoperative OLMH can be a risk factor for the development of postoperative FTMH. Recently, Shimada et al [7] and Ho et al [14] proposed the epi-foveal ILM preservation during ILM peeling. The technique used in the Shimada's study [7] was named 'fovea-sparing ILM peeling', which started away from the central fovea and restarted from a new site when the peeled ILM flap came close to the central fovea.…”

Section: Discussionmentioning

confidence: 99%

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Long-term surgical outcomes of multiple parfoveolar curvilinear internal limiting membrane peeling for myopic foveoschisis

Tian

Jin

Zhou

et al. 2018

Eye

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Section: Discussionmentioning

confidence: 99%

“…The development of FTMH is a serious complication in highly myopic eyes [2,3,[7][8][9][10][11][12][13][14]. To address this, Ho et al [15] and Shimada [7] proposed preserving the epi-foveal ILM during ILM peeling to prevent the formation of FTMH after vitrectomy.…”

Section: Introductionmentioning

confidence: 99%

Long-term surgical outcomes of multiple parfoveolar curvilinear internal limiting membrane peeling for myopic foveoschisis

Tian

Jin

Zhou

et al. 2018

Eye

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“…It has been noted that ILM peeling yields favorable results for MHs larger than 400 μm but does not give the same result for holes with smaller diameters. Ho et al 28 reported that total ILM peeling for holes with small diameters may damage the fovea and is not beneficial in terms of visual outcome. In our study, we performed ILM peeling in all cases and found that base diameter did not affect final visual acuity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Ganglion Cell-Inner Plexiform Layer Thickness after Vitreoretinal Surgery with Internal Limiting Membrane Peeling in Cases with Idiopathic Macular Hole

Demirel¹,

Abdullayev²,

Yanık³

et al. 2017

tjo

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Objectives:To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness after vitrectomy with internal limiting membrane (ILM) peeling for idiopathic macular holes using spectral domain optical coherence tomography (SD-OCT).Materials and Methods:Eighteen eyes of 18 patients with unilateral idiopathic macular hole who underwent vitrectomy with ILM peeling were retrospectively analyzed. Healthy fellow eyes of the patients and 18 eyes of 18 age-matched healthy individuals constituted the control group. The patients were evaluated at 1 day, 1 week, 1 month, and 3 months after surgery. The best corrected visual acuity (BCVA) measurements, biomicroscopic examination findings and SD-OCT measurements were recorded. Ganglion cell-inner plexiform layer thickness was evaluated with ganglion cell analysis software of Cirrus HD-OCT before surgery and at 1 month and 3 months after surgery and compared with control groups. Presence of dissociated optic nerve fiber layer (DONFL) was evaluated with C-scan mode.Results:Of the 18 patients, 9 were male and 9 were female with a mean age of 65.6±5.6 (55-77) years. Preoperative BCVA was 0.75±0.19 logMAR, while it was 0.44±0.17 logMAR and 0.36±0.15 logMAR at postoperative 1 and 3 months, respectively (p<0.001). Postoperative mean GCIPL thickness was 66.33±17.28 µm. There was a correlation between mean GCIPL thickness and BCVA at postoperative 3 months (p<0.01). When compared with the control group, GCIPL thickness was significantly thinner in all quadrants of all patients at postoperative 3 months. Dissociated optic nerve fiber layer appearance was observed on C-scan in 13 of 18 eyes postoperatively. There was no correlation between the presence of DONFL and BCVA (p>0.05).Conclusion:Internal limiting membrane peeling during macular hole surgery may cause functional and/or structural changes that may be associated with visual acuity. Significant GCIPL thinning and DONLF appearance may occur postoperatively.

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“…Foveolar sparing ILM peeling is a less invasive modification of the original ILM peeling technique, which is designed for the treatment of early MHs where the foveal ILM is usually uninvolved. [37] In this procedure, a central piece of ILM of around 400 µm is preserved over the foveola, to reduce foveolar damage and preserve Muller cells. In a small retrospective study comparing traditional ILM peeling with foveolar sparing ILM peeling for early full-thickness IMH (Stage 2), VA improvement and final VA were better in the foveolar sparing group.…”

Section: Foveolar Sparing Ilm Peelingmentioning

confidence: 99%

“…In a small retrospective study comparing traditional ILM peeling with foveolar sparing ILM peeling for early full-thickness IMH (Stage 2), VA improvement and final VA were better in the foveolar sparing group. [37] ILM abrasion ILM abrasion is an alternative to ILM peeling, in which the ILM is gently rubbed around the MH by a diamond-dusted membrane scraper. [38] This technique is designed to eliminate the tractional forces on the retina without the complete removal of the ILM.…”

Section: Foveolar Sparing Ilm Peelingmentioning

confidence: 99%

Idiopathic macular holes – A review of current management strategies

Sela¹,

Hadayer²,

Zahavi³

2019

cleverjournal

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Description of the Condition Macular holes (MHs) are retinal defects which involve the center of the anatomical fovea. [1,2] Severity may range from asymptomatic incidentally discovered MHs, to advanced vision-threatening ones. [2,3] MHs are often described according to the extent of retinal layers involvement. Full-thickness MHs (FTMHs) encompass all the layers of the retina from the internal limiting membrane (ILM) to the retinal pigmented epithelium (RPE) [Figure 1]. [2] Partialthickness MHs, also termed lamellar holes, involve only the inner retinal layers, while the photoreceptors layer may remain intact [Figure 2]. [2,3] Although the majority of cases are idiopathic (>85%), MHs may also be secondary to various conditions, among the most common of which are high myopia and ocular trauma. [2,4,5] Kumawat et al. described in detail other infrequent causes of secondary MHs. [5] Epidemiology The reported prevalence of idiopathic MHs (IMHs) in the general population ranges between 0.02% and 0.33%. [1,4] IMHs are more common in women (approximately 70% of cases) and usually appear in the 6 th and 7 th decades of life. [1,4,6] For patients with an idiopathic FTMH in one eye, the risk for developing an MH in the fellow eye is 10-20%. [1,7] Pathophysiology IMHs are the sequelae of vitreomacular adhesion (VMA) and traction (VMT). [2] The vitreous is a clear gel-like structure enveloped by a hyaloid membrane (the vitreous cortex), the posterior part of which is attached to the ILM of the retina. With aging, the vitreous body liquefies, shrinks, and gradually detaches from the retina, starting at the posterior pole. Physiologically, the vitreous will continue to detach from the retina and eventually remain firmly attached to the retina only at the vitreous base, straddling the ora serrata. In most cases, this process results in no retinal damage. [2,8,9] However, incomplete or abnormal detachment may result in pathologic VMA and VMT, which can distort the foveal contour and result in MH formation [Figure 3]. [8] The traction forces affect the foveola and might impair central vision, causing distorted vision or decreased visual acuity (VA). [2,5,10]

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Foveola nonpeeling internal limiting membrane surgery to prevent inner retinal damages in early stage 2 idiopathic macula hole

Abstract: Nonpeeling of the foveolar ILM in early stage 2 idiopathic MH surgery prevented inner retinal damages, restored umbo light reflex, achieved better foveolar microstructures, and led to better final visual acuity.

Cited by 32 publications

References 32 publications

Long-term surgical outcomes of multiple parfoveolar curvilinear internal limiting membrane peeling for myopic foveoschisis

Long-term surgical outcomes of multiple parfoveolar curvilinear internal limiting membrane peeling for myopic foveoschisis

Evaluation of Ganglion Cell-Inner Plexiform Layer Thickness after Vitreoretinal Surgery with Internal Limiting Membrane Peeling in Cases with Idiopathic Macular Hole

Idiopathic macular holes – A review of current management strategies

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