PURPOSE: To analyze progressive changes of the outer retina after vitrectomy for macular hole (MH) repair. METHODS: Nineteen consecutive patients underwent vitrectomy for idiopathic MH. Spectral domain optical coherence tomography (SD-OCT) examinations were performed pre- and postoperatively during follow-up visits at 1, 3, 6, 9, and 12 months. Active eye-tracking technology ensured that the same scanning location was identified each time. RESULTS: Ten eyes showed a normal external limiting membrane (ELM) at 1 month after surgery and 15 eyes at 3 months. The ELM was already continuous in 79% of the eyes with persistent outer foveal defects during follow-up. No eyes revealed a continuous inner segment/outer segment (IS/OS) line at 1 month, only one eye at 3 months, and 10 eyes at 12 months. No eyes had a disrupted ELM with an intact IS/OS line. Foveal cysts were visible in three eyes at 1 month and in eight eyes during follow-up. The cystic space gradually filled, resulting in a continuous IS/OS line in five of these eyes. Recovery of ELM, IS/OS, and outer nuclear layer (ONL) determined most of visual acuity improvement. The ONL appeared normal in the 10 eyes with an intact IS/OS line at last follow-up. By contrast, it was disrupted in 7 of 9 eyes with a final persistent outer foveal defect. CONCLUSIONS: The ELM is the first structure to recover after MH closure. Foveal cysts may develop during follow-up, and in the presence of an intact ONL, they may gradually fill with complete recovery of the IS/OS junction.
PURPOSE: To analyze progressive changes of the outer retina after vitrectomy for macular hole (MH) repair. METHODS: Nineteen consecutive patients underwent vitrectomy for idiopathic MH. Spectral domain optical coherence tomography (SD-OCT) examinations were performed pre- and postoperatively during follow-up visits at 1, 3, 6, 9, and 12 months. Active eye-tracking technology ensured that the same scanning location was identified each time. RESULTS: Ten eyes showed a normal external limiting membrane (ELM) at 1 month after surgery and 15 eyes at 3 months. The ELM was already continuous in 79% of the eyes with persistent outer foveal defects during follow-up. No eyes revealed a continuous inner segment/outer segment (IS/OS) line at 1 month, only one eye at 3 months, and 10 eyes at 12 months. No eyes had a disrupted ELM with an intact IS/OS line. Foveal cysts were visible in three eyes at 1 month and in eight eyes during follow-up. The cystic space gradually filled, resulting in a continuous IS/OS line in five of these eyes. Recovery of ELM, IS/OS, and outer nuclear layer (ONL) determined most of visual acuity improvement. The ONL appeared normal in the 10 eyes with an intact IS/OS line at last follow-up. By contrast, it was disrupted in 7 of 9 eyes with a final persistent outer foveal defect. CONCLUSIONS: The ELM is the first structure to recover after MH closure. Foveal cysts may develop during follow-up, and in the presence of an intact ONL, they may gradually fill with complete recovery of the IS/OS junction.
Authors: D H W Steel; L Downey; K Greiner; H Heimann; T L Jackson; Z Koshy; D A H Laidlaw; L Wickham; Y Yang Journal: Eye (Lond) Date: 2016-01-15 Impact factor: 3.775
Authors: Justis P Ehlers; Yuji Itoh; Lucy T Xu; Peter K Kaiser; Rishi P Singh; Sunil K Srivastava Journal: Invest Ophthalmol Vis Sci Date: 2014-12-18 Impact factor: 4.799
Authors: Robyn H Guymer; Philip J Rosenfeld; Christine A Curcio; Frank G Holz; Giovanni Staurenghi; K Bailey Freund; Steffen Schmitz-Valckenberg; Janet Sparrow; Richard F Spaide; Adnan Tufail; Usha Chakravarthy; Glenn J Jaffe; Karl Csaky; David Sarraf; Jordi M Monés; Ramin Tadayoni; Juan Grunwald; Ferdinando Bottoni; Sandra Liakopoulos; Daniel Pauleikhoff; Sergio Pagliarini; Emily Y Chew; Francesco Viola; Monika Fleckenstein; Barbara A Blodi; Tock Han Lim; Victor Chong; Jerry Lutty; Alan C Bird; Srinivas R Sadda Journal: Ophthalmology Date: 2019-09-30 Impact factor: 12.079
Authors: Sean Hansen; Sean Batson; Kenneth M Weinlander; Robert F Cooper; Drew H Scoles; Peter A Karth; David V Weinberg; Alfredo Dubra; Judy E Kim; Joseph Carroll; William J Wirostko Journal: Retin Cases Brief Rep Date: 2015