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Kouichi Ohta, Atsuko Sato, Emi Fukui; Residual parafoveal nasal retinal thickening after macular hole surgery with internal limiting membrane peeling. Invest. Ophthalmol. Vis. Sci. 2014;55(13):288.
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We have reported that the parafoveal contour is thicker at the nasal sector and thinner at the temporal sector in the optical coherence tomographic (OCT) images recorded 6 months after successful idiopathic macular hole (MH) closure by pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling (Ohta K. Br J Ophthalmol 2010, Graefes Arch Clin Exp Ophthalmol 2013). The purpose of this study was to determine the long term changes of the parafoveal retinal thickness after MH surgery for up to 4 years
Twenty-seven eyes of 26 patients (13 women and 13 men) with a MH who underwent PPV at the Matsumoto Dental University Hospital were studied. The eyes were examined at 1, 3, 6, 12 months (n=27), and 2 (n=16), 3 (n=10), and 4 (n=5) years after the surgery. The mean retinal thickness was measured in the images obtained by volume scan mode of the Spectralis HRA+OCT (Heidelberg Engineering, Germany). The average retinal thickness of the 4 parafoveal sectors was measured by the built-in software. The thickness of each retinal layer at 1,000 μm from the fovea as the representative thickness of each of the 4 parafoveal sectors was measured in the horizontal and vertical images manually.
The mean parafoveal retinal thickness of the nasal, superior, inferior, and temporal sectors were 361.9±15.3, 341.2±15.4, 339.9±13.7, 313.3±13.6 µm, respectively at 12 months after the surgery. All but the nasal sectors at 3, 6 and 12 months were significantly decreased compared to that at 1 month after the surgery. There was also a significant decrease in only the temporal sector at 12 months compared to that at 6 months. In contrast, the minimum decrease was observed at the nasal sector. There was no significant decrease thereafter in all sectors. A similar tendency of significant decreases of the thicknesses was observed in the inner nuclear layer (INL) and outer nuclear layer (ONL) but not in other retinal layers
The postoperative parafoveal retinal thickness decreased significantly up to 1 year in all but the nasal sectors after MH surgery with ILM peeling. The reduction of the thickness of INL and ONL seemed to be associated with this change.
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