July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Optical coherence tomography angiography of dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for full thickness macular hole
Author Affiliations & Notes
  • Nathan Schuck
    University of British Columbia, Vancouver, British Columbia, Canada
  • Morgan Heisler
    Simon Fraser University, Burnaby, British Columbia, Canada
  • Sherry Han
    Simon Fraser University, Burnaby, British Columbia, Canada
  • Marinko Sarunic
    Simon Fraser University, Burnaby, British Columbia, Canada
  • Eduardo Vitor Navajas
    University of British Columbia, Vancouver, British Columbia, Canada
  • Footnotes
    Commercial Relationships   Nathan Schuck, None; Morgan Heisler, None; Sherry Han, None; Marinko Sarunic, None; Eduardo Navajas, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 879. doi:https://doi.org/
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    • Get Citation

      Nathan Schuck, Morgan Heisler, Sherry Han, Marinko Sarunic, Eduardo Vitor Navajas; Optical coherence tomography angiography of dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for full thickness macular hole
      . Invest. Ophthalmol. Vis. Sci. 2018;59(9):879. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the retinal vascular and structural changes associated with dissociated optic nerve fiber layer (DONFL) appearance after internal limiting membrane (ILM) peeling for full thickness macular hole (FTMH) utilizing optical coherence tomography angiography (OCTA).

Methods : Nine patients with idiopathic FTMH (2 males and 7 females, mean age 71.2±8.4 years) were enrolled in the study. Patients were treated with pars plana vitrectomy, ILM peeling and gas tamponade. Subjects were evaluated at baseline, 1 month, 3 months, and 6 months follow-up visits. At each visit, patients were evaluated with a complete ophthalmologic exam and OCTA.

Results : Mean logMAR visual acuity was 0.88±0.18 at baseline and 0.71±0.27 at 6 months follow-up. DONFL appearance started at 1 month after surgery. DONFL total median area and number of associated dimples were 0.64±0.46mm2, 22±17.59 at 1 month, 2.39±0.73mm2, 71±23.46 at 3 months and 3.139±0.55mm2, 120±31.22 at 6 months follow-up. The median central macular thickness (CMT) change from baseline was +2±11.50µm, -1±4.74 µm and -7±5.14µm at 1, 3, and 6 months follow-up. The outer macula thickness increased at 1 month follow-up as a result of nerve fiber bundle (NFL) swelling and decreased thereafter. Median perifoveal superficial vascular complex density (SVCD) was 37.3±2.44%, 38.5±2.52%, 34.1±4.09%, and 39.2±3.35% at baseline, 1, 3, and 6 months follow-up. This result was not statistically significant.

Conclusions : The present study did not show SVCD reduction in patients with DONFL appearance after ILM peel for FTMH. This may be due to our inability to separate the radial peripapillary capillaries that would most likely be damaged during ILM peel from the superficial capillary plexus during segmentation for vessel density analysis. NFL edema in the early postoperative period may be associated with the development of DONFL appearance.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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