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Adil Darugar, Violaine Caillaux, Ali Erginay, Benedicte Dupas, Valerie Krivosic, Julien Perol, Sebastien Bruneau, Alain Gaudric, Pascale Massin, Ramin Tadayoni; Retinal ganglion cell layer thickness reduces after internal limiting membrane peeling during macular hole surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5766.
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to investigate the potential effect of internal limiting membrane (ILM) peeling during macular hole (MH) surgery on the retinal ganglion cells layer thickness
retrospective comparative case series. Twenty-five eyes of 25 consecutive patients who had undergone surgery for full thickness idiopathic MH with anatomical success, and had a Cirrus ® spectral domain optical coherence tomography (SD-OCT): 18 patients had ILM peeling, and 7 patients did not. The thickness of the retinal ganglion cells layer was measured in the treated eye 3 months after surgery and compared to the fellow eye. Measurements were obtained from a 6 x 6 mm Macular Cube (512 x 128 scans), using the automatic Ganglion Cell Analysis program of the Cirrus 6.0 software (Carl Zeiss Meditec, Dublin, CA). The main outcome measure was the change in the retinal ganglion cell layer thickness in each group
Mean retinal ganglion cell layer thickness in fellow eyes was 80,6 ± 8 microns. A thinning of the retinal ganglion cell layer was observed when the ILM was peeled (-9,2 ± 8 microns, p = 0,001), while unchanged in eyes operated without ILM peeling (+0,7 ± 4 microns). The thinning was bigger in the temporal side of the fovea
ILM peeling induces a thinning of the retinal ganglion cell layer in addition to already published dissociation of the nerve fiber layer (DONFL). This ganglion cell loss could be an explanation for the alterations of retinal sensitivity and microperimetry after ILM peeling reported by several authors
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