Evaluation of Retinal Nerve Fiber Layer Thickness by Optical Coherence Tomography in Eyes with Idiopathic Macular Holes after Vitrectomy with Internal Limiting Membrane Peeling

Abstract

Abstract: : Purpose: To evaluate the changes in retinal nerve fiber layer thickness (RNFLT) in eyes with idiopathic macular holes after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. Methods: Eighteen eyes of 18 patients with idiopathic macular holes were enrolled in the study. RNFLT in all eyes was measured before surgery and at 3 and 6 month after surgery. Measurement of the RNFLT around the optic disc was taken thrice with a 3.4 mm diameter OCT scan. RNFLT measurements in the superior, inferior, nasal and temporal quadrants were analyzed. The temporal quadrant was further divided into 3 segments, each covering an area of 30 degrees (Area A, upper temporal; Area B, medial temporal; Area C, lower temporal). The average RNFLT values from each quadrant and segment were analyzed. Result: Anatomical closure of the holes was achieved in all eyes (100%), as confirmed by OCT. There was no significant difference between the RNFLT values in all quadrants and segments measured pre-operatively and at 3 and 6 months post-operatively. Conclusion: The OCT is a non-invasive tool that could give accurate and repetitive measurements of the RNFLT before and after surgery. This study demonstrated the absence of RNFL thinning until the 6th month post-surgical period. PPV with ILM peeling does not have a significant effect on the anatomy of the RNFL as measured by OCT.

Keywords: macular holes • nerve fiber layer • vitreoretinal surgery