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Amelie Pielen, Daniel Boehringer, Hansjuergen T. Agostini, Bernd Junker; Retinal Nerve Fibre Layer Decreased After Internal Limiting Membrane Peeling In Patients With Idiopathic Epiretinal Membrane And Macular Hole. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2659.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate changes of retinal nerve fibre layer (RNFL) determined by spectral-domain optic coherence tomography (SD-OCT) in patients with idiopathic epiretinal membrane and macular hole (MH) following vitrectomy, epiretinal and internal limiting membrane (ILM) peeling.
SD-OCT scans of 23 patients undergoing vitrectomy for idiopathic epiretinal membrane (n=16) or macular hole (n=7) were obtained in RNFL-mode prior to vitrectomy and 4 months after vitrectomy. RNFL thickness in the temporal (T), temporal superior (TS) and temporal inferior (TI) sector before and after surgery were compared. Secondary endpoints were change of central macular thickness by SD-OCT in the epiretinal membrane subgroup and closure of MH in the other subgroup, change in visual acuity and the morphological structure of the layer representing the inner segments/ outer segments (IS/OS) of photoreceptors classified as intact, partially defect or defect in all patients before and after surgery. Paired T-Test was performed for statistical analysis.
4 months after ILM peeling RNFL decreased significantly in the T sector (mean -15 µm, p=0,001, n=23), but not in the TI and TS sector (TI -1 µm; p=0,7, TS -4 µm; p=0,4). CMT in epiretinal membrane decreased after ILM peeling (mean -52 µm, p= 0,05), all macular holes were closed after surgery. The visual acuity improved from 0,56 to 0,35 logMar (p=0,007, n=23). IS/OS layer was intact in 13 of 16 patients with epiretinal membrane before peeling, 3 partially defect, none defect and did not change after ILM peeling. Only 2 of 7 patients with MH showed intact IS/OS layer after ILM peeling and closure of MH, 4 partially defect and 1 defect.
SD-OCT shows decreased temporal RNFL, but not temporal superior or temporal inferior RNFL after successful ILM peeling in idiopathic epiretinal membrane and macular hole. Almost all patients showed intact IS/OS layer and had a significant improvement of visual acuity.
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