Vitrectomy with or without indocyanine green–assisted peeling of the internal limiting membrane in retinal detachment associated with highly myopic macular hole: an evaluation of anatomic and functional status of macular

Abstract

Abstract: : Purpose: To compare anatomic and functional outcomes of highly myopic eyes with macular hole related retinal detachment surgery (HMRD) with either indocyanine green (ICG) assisted retinal internal limiting membrane (ILM) peeling or laser photocoagulation. Method: In a retrospective study on two consecutive groups of 23 patients (23 eyes) with HMRD and followed for at least 6 months. Twelve patients who underwent ICG–assisted vitrectomy (0.4%, Group 1) and compared with eleven patients without the use of ICG–assisted ILM peeling (Group 2), but additional laser photocoagulation was given in 10 cases postoperatively. The initial hole–closure rate, visual outcome, fundus photographs and Humphrey macular static perimetry were assessed. The foveal tomography monitored by optical coherence tomography (OCT). Results: Closure of the hole was achieved in 21/23 eyes (91%) and detachment retina reattached in all eyes. Although there was no statistically significant difference in improved postoperative visual acuity and the functional outcome, the time of hole closure in ILM–peeling eyes was less than no ILM–peeling eyes and the type of closure based on OCT was significantly different in both groups. The proportion of closed macular hole appearing an interruption in the continuity of feveal tissue was significantly higher in Group 1(8/12 vs.2/11). Conclusion: The anatomical success and visual outcome were similar in both groups postoperatively. ICG–assisted ILM peeling offers the advantage of a faster macular hole closure. OCT detects that persistent macular holes tend to the eyes undergoing ILM peeling and the reason for this may be relation to ILM peeling.

Keywords: macular holes • myopia • retinal detachment