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Kang Yeun Pak, Keun Heung Park, Sung Who Park, Ik Soo Byon, Ji Eun E Lee; Topographic changes of macula after closure of idiopathic macular hole. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1061.
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© ARVO (1962-2015); The Authors (2016-present)
Glial proliferation and centripetal contraction of retinal tissue has been suggested to induce macular hole (MH) closure. However, recent studies have revealed asymmetric elongation of the foveal tissue demonstrating the process involves more than just centripetal contraction. We performed multi-center, retrospective, interventional case series study to investigate retinal displacement in the macula after surgical closure of idiopathic MH and to identify factors correlated with displacement.
A customized program was used to compare the position of the retinal vessels in the macula between pre- and postoperative photographs. The images were processed to enhance vessel visualization, and vascular arcades were matched between two photos. En face images of a 6 x 6 mm optical coherence tomography volume scans were registered to calculate the scale of the photographs. A grid comprising 16 sectors was superimposed on the processed image. The grid contained two rings (inner ring; 2–4 mm and outer ring; 4–6 mm), and each ring was divided into eight sectors. The displacement of the retinal vessels was measured as a vector value by comparing the location of the retinal vessels in each sector. The correlation between displacement and various clinical parameters, including size of internal limiting membrane (ILM) removal and MH diameter, was analyzed.
This study enrolled 73 eyes of 73 patients. The average displacement was 57.2 μm at an angle of –3.3 degree (nasal and slightly inferior). Displacement was larger in the inner ring (79.2 μm) than in the outer ring (35.3 μm, p < 0.001), and larger in the temporal sectors than in the corresponding nasal sectors (p ≤ 0.008). Inferior and superior displacement was observed in the superior and inferior sectors, respectively. Multiple regression analysis revealed that basal horizontal MH diameter and ILM removal size were an independent factor of displacement distance.
The macula was displaced centripetally, nasally, and slightly inferiorly after surgical closure of idiopathic MH. Hole closure, contraction of the nerve fiber layer, and gravity are the suggested causes of retinal displacement, caused by ILM peeling.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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