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Antonio Ciardella, Nicole Balducci, Alessandro Finzi, Mariachiara Morara, Chiara Veronese, Carlo Torrazza, Roberto Gattegna, Tommaso Perossini; Retinal nerve fiber layer (RNFL) thickness modification after internal limiting membrane (ILM) peeling: 45 months follow-up. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5119.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate RNFL thickness modification after ILM peeling for idiopathic macular hole (MH) or epiretinal membrane (ERM) during a follow up period of 45 months.<br />
Interventional, prospective, non randomized case series. Twenty eyes of 20 patients (76,7±6,6 years) who underwent pars plana vitrectomy and brilliant blue G-assisted ILM peeling were evaluated 24,2±1.2 and 45,6±1,4 months after surgery. All the patients received a complete ophthalmic examination, autoﬂuorescence, infrared and blue light images, peripapillary and macular SD-OCT (Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany), visual field test (Humphrey central 30-2) in both eyes. Six peripapillar sector (superotemporal, temporal, inferotemporal, nasal, superonasal, inferonasal) and global RNFL thickness were evaluated. Data were compared with the data of the same patients obtained preoperatively and 1, 3 and 6 months postoperatively, that had already been analyzed in a previous study. Data were analyzed using Friedman, Wilcoxon and Spearman tests.<br />
Best corrected visual acuity, expressed in LogMAR, significantly improved after surgery, remained stable at the 45 months follow-up (0,41±0,25 vs 0,12±0,2, p<0,01) and it was not statistically different from the early postoperative values. Sectoral and global RNFL thickness showed statistically significant modifications during the follow up period (p<0,0001). Specifically, after an initially significative increase of RNFL thickness in all the sectors, but the temporal one, 1 month post surgery, a progressive decrease of global, superotemporal, temporal and inferotemporal RNFL thickness was detectable 6 months after surgery. The RNFL thickness reduction in these sectors did not change after 24 and 45 months of follow-up (p< 0,001 when compared to preoparative values and p>0,05 when compared to 6 months values).
ILM peeling leads to significant peripapillar RNFL thickness modification in the early postoperavite period and it is not responsible for further retinal nerve fiber loss. The superotemporal, temporal and inferotemporal thickness reduction detectable 6 months after surgery did not change during a follow up period of 45 months.
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