Retinal Displacement Toward Optic Disc After Internal Limiting Membrane Peeling for Idiopathic Macular Hole

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

“…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]. One possible explanation for this movement may be associated with shrinkage of the optic nerve fibers after ILM peeling [18].…”

“…This displacement was confirmed by other studies [18,19]. One possible explanation for this movement may be associated with shrinkage of the optic nerve fibers after ILM peeling [18]. ILM peeling might cause microtubules to depolymerize by unknown biologic causes or bare retinal nerve fibers, which might be more likely to be influenced by intravitreal chemical factors and make the nerve fibers around the ILM peeled area shrink.…”

“…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.…”

Internal Limiting Membrane Peeling in Macular Hole Surgery; Why, When, and How?

“…A variety of morphologic changes in the retina have been noted after ILM peeling, including a movement of the fovea toward the optic nerve head, which has been associated with thickening of the nasal retina and thinning of the temporal retina. 30,50 The retinal movement is centripetal but with greater movement in the horizontal meridian than vertical, and greater movement of the temporal retina toward the disc than nasal. 50,51 The observed retinal displacement has been related to the extent of postoperative metamorphopsia and also the postoperative appearance of a DONFL.…”