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Homayoun Tabandeh, Andy Morozov, David S Boyer; “En face” Imaging of ILM Flap Following Macular Hole Surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3640.
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© ARVO (1962-2015); The Authors (2016-present)
To visualize and evaluate the internal limiting membrane (ILM) flap following macular hole (MH) surgery.
Retrospective case series including eyes that underwent pars plana vitrectomy (PPV) and ILM flap for MH. Postoperatively, ICG fluorescence images were obtained using a confocal laser scanning system (Spectralis, Heidelberg Engineering Inc., Heidelberg, Germany) with the 795 nm ICG filter. Optical coherence tomography (OCT) was used to evaluate the status of the MH.
Twenty eyes of 20 patients, mean age 67.2 years, with mean follow-up of 11.1 months were included in the study. Five (25%) eyes were highly myopic, 8 (40%) eyes had chronic MH, and 3 (18%) eyes had history of prior MH surgery and ILM removal. The MH closed in 19 (95%) eyes. Typically the ICG fluorescence imaging showed a well defined area of hypofluorescence corresponding to the harvest site and removed ILM, an area of hyperfluorescence corresponding to the ILM flap and the residual ILM, and an area of increased hyperfluorescence corresponding to the overlap area of ILM flap with the residual ILM. Hyperfluorescence over the MH site, and speckled hyperfluorescence over the macular region were present in most eyes. ICG fluorescence imaging demonstrated coverage of the MH by the ILM flap in 17 (85%) eyes, partial coverage in 1 (5%) eye, and no coverage in 2 (10%) eyes. Folding of the ILM flap was present in 5 (25%) eyes. OCT demonstrated bridging of the fovea by the ILM flap in 4 (20%) eyes.
ICG fluorescence imaging is a non-invasive imaging modality that provides an “en face” image of the ILM flap following MH surgery, allowing study of ILM flap techniques.
This is a 2021 ARVO Annual Meeting abstract.
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