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Jae Hui Kim, Se Woong Kang, Jaeryung Kim; Notching of tissue after macular hole surgery : An abrupt alteration in inner contour of parafoveal tissue associated with foveal tissue elongation. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2802.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the significance of notching in parafoveal tissue after surgery for macular hole (MH).
This retrospective, observational case series included 35 eyes from 35 patients who underwent surgery for MH. Distance between the parafoveal edge of the outer plexiform layer (OPL) in optical coherence tomography image (OCT) was defined as the inter-OPL distance. The horizontal and vertical inter-OPL distance was divided into nasal and temporal length, and superior and inferior length, respectively. The inter-OPL distance was measurable in 22 eyes. In these eyes, all the nasal, temporal, superior, and inferior lengths were divided into two groups according to presence of the notching of tissue on OCT image at postoperative 6 to 8 months. The difference in inter-OPL distance between 5.4 ± 4.5 weeks postoperatively in average and 6.6 ± 0.8 months postoperatively in average was compared between the two groups.
The mean MH size was 436.6 ± 209.7 μm. The notching of tissue was noted in 26 eyes (74.3%) regardless of MH size; nasal direction=22 eyes (62.9%), temporal direction=10 eyes (28.6%), superior direction=12 eyes (34.3%), inferior direction=14 eyes (40.0%). In the 22 eyes, the mean difference in length was 82.4 ± 72.1 μm and 47.9 ± 60.6 μm in the directions with and without the notching of tissue. The difference in the distance was significantly greater in the directions with notching (P=0.017).
The presence of notching could be a tomographic marker for the development of the elongation in foveal tissue after MH surgery. Presence of the notching regardless of MH size suggests that postoperative elongation of foveal tissue occurs in large MHs as well as in small MHs.
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