Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery

Ye, Xin; He, Shucheng; Wang, Jun; Yang, Jinglei; Tao, Jiwei; Chen, Yiqi; Shen, Lijun

doi:10.1038/s41433-022-02150-y

Cited by 4 publications

(9 citation statements)

References 29 publications

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“…For example, Tada et al [ 18 ], by using retinal thickness maps, found that ILM peeling resulted in progressive thinning of the temporal inner retina at 6 months postoperatively, but no significant changes were found in the nasal inner retina. In addition, the distribution pattern of changes in IRL thickness is highly similar to what we have in our previous quantitative study of DONFL: the severity of DONFL was greater on the temporal side than in the other quadrants [ 24 ]. Given that DONFL is an inner retinal appearance and that the distribution of changes in ORL did not have a similar pattern to that of DONFL, we speculate that the formation of DONFL might be related to a reduction in IRL thickness.…”

Section: Discussionsupporting

confidence: 82%

Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study

Qiu

et al. 2023

JPM

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(1) Purpose: This study aimed to evaluate morphological changes of the retina in eyes with dissociated optic nerve fiber layer (DONFL) appearance following internal limiting membrane (ILM) peeling for full-thickness idiopathic macular hole (IMH) on spectral-domain optical coherence tomography (SD-OCT). (2) Methods: We retrospectively analyzed 39 eyes of 39 patients with type 1 macular hole closure after a vitrectomy with ILM peeling procedure at a six-month minimum postoperative follow-up. The retinal thickness maps and cross-sectional OCT images were obtained from a clinical OCT device. The cross-sectional area of the retinal nerve fiber layer (RNFL) on cross-sectional OCT images was manually measured by ImageJ software. (3) Results: The inner retinal layers (IRLs) thickness thinned down much more in the temporal quadrant than in nasal quadrants at 2 and 6 months postoperatively (p < 0.001). However, the cross-sectional area of the RNFL did not change significantly at 2 and 6 months postoperatively (p > 0.05) when compared to preoperative data. In addition, the thinning of the IRL did not correlate with the best-corrected visual acuity (BCVA) at 6 months postoperatively. (4) Conclusions: The thickness of the IRL decreased in eyes with a DONFL appearance after ILM peeling for IMH. The thickness of the IRL decreased more in the temporal retina than in the nasal retina, but the change did not affect BCVA during the 6 months after surgery.

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Section: Discussionsupporting

confidence: 82%

Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study

Qiu

et al. 2023

JPM

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“…Using the temporal inverted ILM flap technique, the incidence of DONFL was significantly reduced on B-scan OCT. 34 However, our previous studies on en-face OCT using computer aids demonstrated that DONFL is mainly concentrated in the temporal quadrant. 16 We speculate that this distribution pattern may be related to a thinner retina and…”

Section: Discussionmentioning

confidence: 83%

“…26 The incidence and severity of DONFL increased over time from 1 to 6 months after surgery, 26,27 and stabilized 6 months after the surgery. 16,28 For a long time DONFL was thought to be an anatomical appearance that did not affect visual function and was associated primarily with dissociation rather than loss of nerve fibers. 29,30 However, recent studies have suggested that DONFL may not be merely a modification of the nerve fiber layer, but may involve the GCL-IPL complex, 31 which led the researchers to wonder if DONFL appearance might cause some potential changes in visual function.…”

Section: Discussionmentioning

confidence: 99%

“…Fewer studies count DONFL in each of the central 13 slices in OCT B‐scan, or describe it as “mild,” “moderate,” or “severe” in en‐face OCT. All of these assessments had limitations. In our previous study, we developed a MATLAB‐based automated system to quantitatively assess the DONFL 16 . A novel system using the local adaptive thresholding (LAT) algorithm was developed for the detection and location of the DONFL on en‐face OCT images.…”

Section: Introductionmentioning

confidence: 99%

“…8,13 For the distribution pattern of DONFL, some literature reported, DONFL mainly occurred on the temporal side of the macula on en face OCT images, 14,15 Our previous study confirmed it. 16 The influence of DONFL on the visual function is controversial. Some scholars found it was related to a reduction in central retinal sensitivity and paracentral scotomas.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the inner retinal layers following traditional and modified ILM peeling surgery using automatic CMDS quantification algorithm

Shen,

Ye,

et al. 2023

VIEW

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Idiopathic macular hole (IMH) is a vitreoretinal disease that causes severe visual impairment, and the pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) is the traditional treatment for IMH. Since the dissociated optical nerve fiber layer (DONFL) is observed in the eyes after the surgery, a modified surgery is put forward to minimize the injury. However, the extent to which the modified surgery reduced damage is not clear. A novel automated image processing system was developed in this study to quantify the damage after the surgery, revealing how the modified surgery reduced the DONFL. Optical coherence tomography (OCT) images and visual acuity were collected from 65 eyes that underwent a vitrectomy with traditional and modified ILM peeling procedure at Zhejiang Provincial People’s Hospital preoperatively. We found that DONFL occurred in all 65 eyes of both the traditional and modified ILM peeling groups. The concentric macular dark spots (CMDS) were automatically measured by the image processing system. The mean total area of CMDS was smaller in the modified ILM peeling group (0.224 ± 0.110 mm2) than that of the traditional ILM peeling group (0.385 ± 0.237 mm2), and there is a significant difference between the two groups (p < .05). The morphological difference in the temporal quadrant of CMDS between the two surgery technology groups was significant (p < .001). This study will provide a clinical research basis for the improvement of macular hole surgery.

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Three-Dimensional Quantitative Analysis of Internal Limiting Membrane Peeling Related Structural Changes in Retinal Detachment Repair

Hsieh,

Wang,

Chen

et al. 2025

American Journal of Ophthalmology

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Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery

Cited by 4 publications

References 29 publications

Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study

Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study

Evaluation of the inner retinal layers following traditional and modified ILM peeling surgery using automatic CMDS quantification algorithm

Three-Dimensional Quantitative Analysis of Internal Limiting Membrane Peeling Related Structural Changes in Retinal Detachment Repair

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