Abstract
Purpose :
To analyze long-term changes of the retinal structure using spectral-domain optical coherence (SD-OCT) after macular hole (MH) surgery.
Methods :
Twenty-nine eyes of 29 patients with MH were studied. They consisted of 17 women and 12 men, ranging in age from 60 to 77 with an average of 66.4. They underwent phacovitrectomy with peeling the internal limiting membrane (ILM). The area of the ILM peeling was approximately 2 discs in diameter. To invest effect of cataract surgery, we also included 16 cataract patients who underwent only cataract surgery. We prospectively recorded SD-OCT pre-operatively and at the week 2 post-operatively with following every 3-month observation until the month 12 and afetrwards every 6-month observation until the month 24. Automatic segmentation software was used to measure the ganglion cell complex (GCC) and outer retinal layer (ORL) thickness in parafoveal (1.5 to 4.5 mm from the fovea in radius) and paramacular (4.5 to 9.0 mm) regions, respectively. Each region was divided into superior/temporal, superior/nasal, inferior/temporal and inferior/nasal quadrants for analysis.
Results :
The GCC thickness significantly reduced in all quadrants in the parafoveal region until the month 3 without subsequent change afterwards until the month 24. The GCC thickness in the paramacular increased after surgeries, which was also found in patients who underwent only cataract surgery. The ORL thickness significantly increased at month 1 or 3 postoperatively and did not return the pre-operative value until the month 24. This ORL change was not observed in the cataract patients.
Conclusions :
The inner retinal thinning was confined to the parafoveal region corresponding to the ILM-peeling area. However, the outer retinal thickening extended to the outside of the ILM-peeling area, which could not be explained by optical changes brought by cataract surgery.
This is a 2020 ARVO Annual Meeting abstract.