Incidence and quantitative analysis of dissociated optic nerve fiber layer appearance: real loss of retinal nerve fiber layer?

Kim, Yoon J; Lee, Kyoung S.; Joe, Soo Geun; Kim, June-Gone

doi:10.5301/ejo.5001067

Cited by 14 publications

(12 citation statements)

References 39 publications

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“…Studies have shown anatomical and functional alterations because of that however without affecting the final visual outcome of the intervention. 24 , 37 …”

Section: Discussionmentioning

confidence: 99%

Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

et al. 2020

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Purpose: The aim of this study is to analyze the effect of internal limiting membrane peeling in removal of idiopathic epiretinal membranes through meta-analysis. Methods: We searched PubMed for studies published until 30 April 2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without internal limiting membrane peeling. Exclusion criteria consisted of coexisting retinal pathologies and use of indocyanine green to stain the internal limiting membrane. Sixteen studies were included in our meta-analysis. We compared the results of surgical removal of epiretinal membrane, with or without internal limiting membrane peeling, in terms of best-corrected visual acuity and anatomical restoration of the macula (central foveal thickness). Studies or subgroups of patients who had indocyanine green used as an internal limiting membrane stain were excluded from the study, due to evidence of its toxicity to the retina. Results: Regarding best-corrected visual acuity levels, the overall mean difference was –0.29 (95% confidence interval: –0.319 to –0.261), while for patients with internal limiting membrane peeling was –0.289 (95% confidence interval: –0.334 to –0.244) and for patients without internal limiting membrane peeling was –0.282 (95% confidence interval: –0.34 to –0.225). Regarding central foveal thickness levels, the overall mean difference was –117.22 (95% confidence interval: –136.70 to –97.74), while for patients with internal limiting membrane peeling was –121.08 (95% confidence interval: –151.12 to –91.03) and for patients without internal limiting membrane peeling was –105.34 (95% confidence interval: –119.47 to –96.21). Conclusion: Vitrectomy for the removal of epiretinal membrane combined with internal limiting membrane peeling is an effective method for the treatment of patients with idiopathic epiretinal membrane.

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“…Studies have shown anatomical and functional alterations because of that however without affecting the final visual outcome of the intervention. 24 , 37 …”

Section: Discussionmentioning

confidence: 99%

Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

et al. 2020

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“…Grundsätzlich sind Veränderungen der Neuroretina, die nach einem Peeling der ILM häufig beobachtet werden, weniger Ausdruck einer akuten mechanischen Schädigung durch die chirurgische Manipulation als Ausdruck einer Reorganisation der retinalen Strukturen nach dem Entfernen der membranbedingten Traktionen [66]. Trotz des offensichtlichen Vorteils einer Reduktion der ERM-Rezidivrate sollte aber insbesondere in Fällen, in denen eine sehr starke Adhäsion der ILM vorliegt, die Entscheidung zu einem forcierten und möglicherweise risikoreichen Peeling immer auch im individuellen Fall abgewogen werden, da eine Schädigung durch die chirurgische Manipulation bei der Mobilisierung eines ILM-Flaps nicht ausgeschlossen werden kann [22,137].…”

Section: Entfernen Der Membrana Limitans Interna (Ilm-peeling)unclassified

“…In jüngerer Zeit wurde außerdem über eine negative Korrelation zwischen dem Vorhandensein "ektopischer innerer fovealer Schichten" (EIFL) und der prä-und postoperativen bestkorrigierten Sehschärfe berichtet [38]. Keinen wesentlichen Einfluss auf die postoperative funktionelle Entwicklung scheint die meist 1 bis 3 Monate nach einem ILM-Peeling beobachtete Dissoziation der Optikusfaserschicht der Retina (DONFL) zu haben [66,89]). Darüber hinaus kann es zum Auftreten von Funktionseinschränkungen, wie z.…”

Section: Aufklärungsgesprächunclassified

Stellungnahme von BVA, DOG und RG zur Entwicklung, Diagnostik und Behandlung der epiretinalen Gliose

2021

Klin Monbl Augenheilkd

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“…Since the appearance of DONFL is not common in patients who have undergone vitrectomy without ILM peeling [2,3], it is thought that ILM peeling is certainly involved in its occurrence. Reportedly, DONFL appearance commonly occurs at 1-3 months after vitrectomy, and thereafter, persists in some patients or becomes slightly less distinct in other patients [5,6]. Although the incidence of DONFL varies from report to report, it apparently occurs in approximately 30-60% of MHs in which an ILM peel is performed [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Reportedly, DONFL appearance commonly occurs at 1-3 months after vitrectomy, and thereafter, persists in some patients or becomes slightly less distinct in other patients [5,6]. Although the incidence of DONFL varies from report to report, it apparently occurs in approximately 30-60% of MHs in which an ILM peel is performed [1][2][3][4][5][6]. Although previous studies have suggested various factors associated with DONFL appearance, its exact cause remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Involvement of Anoikis in Dissociated Optic Nerve Fiber Layer Appearance

Ikeda

Nakamura²,

Sato

et al. 2021

IJMS

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Dissociated optic nerve fiber layer (DONFL) appearance is characterized by dimpling of the fundus when observed after vitrectomy with the internal limiting membrane (ILM) peeling in macular diseases. However, the cause of DONFL remains largely unknown. Optical coherence tomography (OCT) findings have indicated that the nerve fiber layer (NFL) and ganglion cells are likely to have been damaged in patients with DONFL appearance. Since DONFL appearance occurs at a certain postoperative period, it is unlikely to be retinal damage directly caused by ILM peeling because apoptosis occurs at a certain period after tissue damage and/or injury. However, it may be due to ILM peeling-induced apoptosis in the retinal tissue. Anoikis is a type of apoptosis that occurs in anchorage-dependent cells upon detachment of those cells from the surrounding extracellular matrix (i.e., the loss of cell anchorage). The anoikis-related proteins βA3/A1 crystallin and E-cadherin are reportedly expressed in retinal ganglion cells. Thus, we theorize that one possible cause of DONFL appearance is ILM peeling-induced anoikis in retinal ganglion cells.

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Incidence and quantitative analysis of dissociated optic nerve fiber layer appearance: real loss of retinal nerve fiber layer?

Cited by 14 publications

References 39 publications

Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

Stellungnahme von BVA, DOG und RG zur Entwicklung, Diagnostik und Behandlung der epiretinalen Gliose

Involvement of Anoikis in Dissociated Optic Nerve Fiber Layer Appearance

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