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Ivana Svorenova, Ali Erginay, Peter Strmen, Alain Gaudric, Pascale Massin, Ramin Tadayoni; Decreased Retinal Sensitivity After Macular Hole Surgery With Internal Limiting Membrane Peeling. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4465.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the retinal sensitivity and occurrence absolute or relative scotomata found by microperimetry after closure of idiopathic macular hole with or without internal limiting membrane (ILM) peeling.
In 16 eyes combined Spectral OCT/SLO topography and microperimetry (OPKO/OTI, Miami, USA) was performed 1 to 120 months after closure of an idiopathic macular hole. In 8 eyes ILM was peeled, in 7 eyes was not peeled, and in 1 eye the closure of the macular hole was spontaneous. All patients received an ophthalmologic examination, color fundus photography and OCT + microperimetry performed by combined Spectral OCT/SLO. A customized microperimetry pattern with 29 measurement points was used. Results are presented as mean ± standard deviation.
Postoperative microperimetry defects were significantly more frequent after ILM peeling than without ILM peeling: 11.3 ± 6.6 points with retinal sensitivity less than 10 dB in the group of patients with ILM peeling vs. 2.9 ± 4.6 in the group of patients without ILM peeling (p=0.0093). The average sensitivity in dB was also lower after ILM peeling: 9.80 ± 2.35 dB in the group of patients with ILM peeling vs. 13.19 ± 2.92 in the group of patients without ILM peeling (p=0.0209).
We had shown that ILM peeling results in discreet but detectable anatomical alterations of the retinal: Dissociated Optic Nerve Fiber Layer (DONFL). Here, the results of our study show significantly lower retinal sensitivity and higher incidence of scotomata in eyes after idiopathic macular hole surgery with ILM peeling compared to macular holes closed without peeling. A randomized study is needed to confirm these results. If confirmed this should lead to a more strict selection of techniques and patients in which ILM should be peeled.
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